Last updated July 6, 2026
Key finding
The intervention group demonstrated a significant improvement in MARS-5 scores (24.23 ± 1.34) compared to the control group (19.00 ± 3.20) (P = 0.000).
Telehealth through SMS reminders significantly improved statin adherence and reduced cholesterol levels in patients with diabetes.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
Telehealth through SMS reminders significantly improved statin adherence and reduced cholesterol levels in patients with diabetes.
Improving medication adherence is crucial for managing diabetes and preventing cardiovascular diseases. The findings suggest that simple, low-cost interventions like SMS reminders can lead to better health outcomes for patients, potentially reducing the burden of chronic diseases and healthcare costs.
The study did not measure long-term adherence beyond the intervention period. Results may not be generalizable to all diabetic populations. The impact of SMS reminders on clinical outcomes like heart events was not significant.
Published in
Publication details and source links for this paper.
Amna AD, Neama MM, Mohammad HA, Eman MH. Telehealth through SMS improves statin adherence in patients with diabetes. BMC Health Services Research. 2025;25:1150. doi:10.1186/s12913-025-13295-3
Adherence rate improved significantly in the intervention group (MARS-5: 24.23 ± 1.34 vs. 19.00 ± 3.20, P = 0.000).
Pill count adherence increased significantly in the intervention group (99.07 ± 2.75 vs. 90.41 ± 7.68, P = 0.000).
Total cholesterol decreased significantly in the intervention group (135.26 ± 52.62 vs. 186.85 ± 54.89, P = 0.000).
LDL-c levels decreased significantly in the intervention group (71.09 ± 46.66 vs. 108.42 ± 51.93, P = 0.001).
Evidence network
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This study contributes evidence to SMS text messaging behavioral intervention for health promotion and Adherence rate (MARS-5), All-cause mortality, Cardiovascular events, and 3 more.
This study contributes evidence to
Primary intervention
SMS text messaging behavioral intervention for health promotion
Primary outcomes
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
6
Evidence pairs
308
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
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Core evidence
The primary outcomes reported in this study.
SMS text messaging behavioral intervention for health promotion → Adherence rate (MARS-5)
SMS text messaging behavioral intervention for health promotion → Adherence rate (MARS-5)
SMS text messaging behavioral intervention for health promotion → All-cause mortality
SMS text messaging behavioral intervention for health promotion → All-cause mortality
SMS text messaging behavioral intervention for health promotion → Cardiovascular events
SMS text messaging behavioral intervention for health promotion → Cardiovascular events
SMS text messaging behavioral intervention for health promotion → LDL cholesterol
SMS text messaging behavioral intervention for health promotion → LDL cholesterol
SMS text messaging behavioral intervention for health promotion → Pill count adherence
SMS text messaging behavioral intervention for health promotion → Pill count adherence
SMS text messaging behavioral intervention for health promotion → Total cholesterol
SMS text messaging behavioral intervention for health promotion → Total cholesterol
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and Adipokine and Angiogenic Markers, Diabetes Self-Management Education and Support (DSMES) Programs and Adipokine and Angiogenic Markers.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring Adipokine and Angiogenic Markers
Measures Adipokine and Angiogenic Markers as a key outcome.
All studies on Diabetes Self-Management Education and Support (DSMES) Programs
Contributes to Diabetes Self-Management Education and Support (DSMES) Programs evidence base.
All studies measuring Adherence rate (MARS-5)
Measures Adherence rate (MARS-5) as a key outcome.
Latest published studies
Published within the last 2 years.
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2 results
2 results
2 results
2 results
2 results
Generated from the study's connected evidence using Evidence Intelligence™.
Diabetes Self-Management Education and Support (DSMES) Programs may improve Adipokine and Angiogenic Markers.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Total cholesterol
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Consistent | 1 study
LDL cholesterol
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Diabetes Self-Management Education and Support (DSMES) Programs may improve Cardiovascular Outcomes.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
All-cause mortality
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Cardiovascular events
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 3 supporting studies with generally consistent results and a positive effect signal.
Limitations
SMS text messaging behavioral intervention for health promotion appears to improve Adherence rate (MARS-5).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adherence rate (MARS-5)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
SMS text messaging behavioral intervention for health promotion appears to improve Pill count adherence.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Pill count adherence
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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