Background: Medication Event Monitoring System (MEMS) technology in glaucoma medication adherence has not yet addressed reminder fatigue, in which patients become desensitized to reminders after repeated exposure.

Aims: To study how the prototype of a novel device, which couples real-time monitoring with custom SMS text reminders, can affect medication adherence.

Methods: We piloted a randomised prospective clinical trial, recruiting patients between June 2017 to February 2018 from the Stanford Byers Eye Institute who had been prescribed daily latanoprost for open-angle glaucoma. We monitored each participant’s usage for 13 weeks, randomising each participant into one of three arms: Arm 1 controls were monitored, Arm 2 subjects were also notified via SMS texts for missed doses, and Arm 3 subjects were monitored, notified via SMS texts for missed doses, and called monthly and/or if adherence fell below 75% to collect qualitative data on reasons for lack of adherence.

Results: Of 78 subjects who were consented, 50 subjects participated. By week 7, Arm 1 subjects had a decline in adherence compared to Arm 2, which had maintained its adherence at 78.57 ± 5.13% (p= 0.01). Arm 3 subjects maintained a steady adherence for the first 5 weeks; however, at week 6 their adherence peaked at 90.48 ± 4.12%, compared to Group 1 which had fallen to 46.43 ± 15.68% (p = 0.01).

Conclusions: Real-time custom reminders can improve glaucoma medication adherence. This pilot can aid future clinical trial design in assessing real-time electronic monitoring and custom reminders in glaucoma medication adherence.

Keywords: Adherence, Glaucoma, Reminder, Real-time, Monitoring

Background: Despite influenza vaccination being recommended, widely accessible and available free of charge for all pregnant women in Australia, vaccine coverage remains low. Novel strategies to increase uptake of influenza vaccine by pregnant women need to be explored.

Aims: This report aims to describe the implementation of a customised educational video about maternal influenza vaccination sent by text message, and its impact on maternal influenza vaccine uptake.

Methods: We trialled a customised video message as a strategy to improve maternal influenza vaccination coverage. Two hospitals in regional Victoria produced videos featuring senior local maternity care providers conveying information on the seriousness of maternal influenza infection and the benefits of maternal influenza vaccine. A link to the video was sent via text message to all pregnant women registered to give birth at that health service. Women were subsequently asked to complete a questionnaire about access to and relevance of the video.

Results: In May and August 2019 respectively, 842 and 742 text messages were sent. 233 pregnant women completed the questionnaire. 72 (31%) recalled receiving a text message. 26/72 (36%) of respondents watched the video, and 35% were motivated to receive influenza vaccine by the video. More than 70% of those who viewed the video confirmed that it was relevant and easy to understand.

Conclusion: Sending health information using a personalised video delivered via text message is a novel and acceptable method to provide maternal vaccine recommendation to pregnant women. This intervention could be considered along with other strategies to improve maternal vaccine uptake.

Keywords: maternal immunisation, text message video link, health promotion, influenza vaccine, pregnancy