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Bidirectional Text Messaging to Improve Adherence to Recommended Lipid Testing.

  • Author(s): Baldwin, Laura-Mae;
  • Morrison, Caitlin;
  • Griffin, Jonathan;
  • Anderson, Nick;
  • Edwards, Kelly;
  • Green, Jeff;
  • Waldren, Cleary;
  • Reiter, William
  • et al.


Synergies between technology and health care in the United States are accelerating, increasing opportunities to leverage these technologies to improve patient care.


This study was a collaboration between an academic study team, a rural primary care clinic, and a local nonprofit informatics company developing tools to improve patient care through population management. Our team created a text messaging management tool, then developed methods for and tested the feasibility of bidirectional text messaging to remind eligible patients about the need for lipid testing. We measured patient response to the text messages, then interviewed 8 patients to explore their text messaging experience.


Of the 129 patients the clinic was able to contact by phone, 29.4% had no cell phone or text-messaging capabilities. An additional 20% refused to participate. Two thirds of the 28 patients who participated in the text messaging intervention (67.9%) responded to at least 1 of the up to 3 messages. Seven of 8 interviewed patients had a positive text-messaging experience.


Bidirectional text messaging is a feasible and largely acceptable form of communication for test reminders that has the potential to reach large numbers of patients in clinical care.

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