SPPA trial (A multicenter, assessor-blinded, controlled, randomised, parallel group, superiority, pragmatic trial assessing the effectiveness of daily SMS-reminders in Pharmaceutical Care of older adults with hypertension on improving Patients’ Adherence to blood pressure-lowering medication)

Hypertension belongs to the main risk factors of cardiovascular diseases, which are the leading cause of morbidity and mortality in the world. Despite the availability of effective antihypertensive treatment, blood pressure control remains a serious problem. Poor adherence to antihypertensive medication is considered to be the key factor for uncontrolled blood pressure. Slovak studies report alarmingly low adherence rates (15-19%). The majority of interventions aimed at increasing patients’ adherence are associated with substantial costs and professionals capacity, both lacking in the Slovak health care system. Studies have shown the efficiency of SMS reminders to improve patients’ adherence and health outcomes. SMS messages are a popular means of communication among Slovaks hence; this approach could be feasible also in Slovakia. Pharmacists are highly trained drug experts, who have the knowledge, skills and time to address patients’ nonadherence. Thus, the primary objective of the SPPA trial is to ascertain if daily SMS reminders of blood pressure-lowering medication intake provided by pharmacists in addition to the standard pharmaceutical care increase the proportion of adherent older hypertensive ambulatory patients. The SPPA trial is designed as a pragmatic randomised controlled assessor blinded multicentre superiority trial with two parallel groups (1:1) to assess the effectiveness of daily SMS reminders of blood pressure-lowering medication provided by pharmacists in addition to the usual pharmaceutical care compared to the usual pharmaceutical care only. Patients will be randomised into 2 groups: the intervention group (receiving daily SMS reminders of medication intake) and control group (receiving usual pharmaceutical care only). The SPPA trial presents an original solution to the problem of low adherence to medication in older patients with hypertension in Slovakia. By engaging pharmacists in the process of enhancing patients’ adherence via SMS reminders, both the patients and the health care system could benefit more from their professional capacity and experience. The intervention requires almost none financial resources and training. Furthermore, this additional pharmaceutical service would strengthen the relationship and trust between patients and their pharmacists contributing to even more effective health care provision. We strive to collect patient reported outcomes as well as their feedback on the intervention.

Journal Ref. HARAMIOVA, Z., The effectiveness of daily SMS reminders in pharmaceutical care of older adults on improving patients' adherence to antihypertensive medication (SPPA): study protocol for a randomized controlled trial. Trials, Jul 2017, 18
Intervention Behavioural change (patients) - SMS reminders of blood pressure-lowering medicines intake
Number of sites 6
Countries involved Slovakia
Sample size 300
Type of statistical analyses Intention to treat
Risk of bias Overall: Low Risk details
Participant characteristics Age: >= 55 years
Condition: primary hypertension
Baseline severity: N/A
Duration of trial 3 months
Primary outcome Proportion of adherent patients in the intervention group after 3 months of receiving SMS reminders of medication intake compared to the control group
Show Score Ranges


(shows median if more than one score was entered)

Elig. Recr. Setting Org. Int. Flex. Del. Flex. Adherence Follow-Up Prim. Out. Prim. An.
5 5 5 3 5 -1 4 3 5