Effects of and satisfaction with short message service reminders for patient medication adherence: a randomized controlled study.

BACKGROUND: Medication adherence is critical for patient treatment. This study involved evaluating how implementing Short Message Service (SMS) reminders affected patient medication adherence and related factors. METHODS: We used a structured questionnaire to survey outpatients at three medical centers. Patients aged 20 years and older who were prescribed more than 7 days of a prescription medication were randomized into SMS intervention or control groups. The intervention group received daily messages reminding them of aspects regarding taking their medication; the control group received no messages. A phone follow-up was performed to assess outcomes after 8 days. Data were collected from 763 participants in the intervention group and 435 participants in the control group. RESULTS: After participants in the intervention group received SMS reminders to take medication or those in the control group received no messages, incidences of delayed doses were decreased by 46.4 and 78.8% for those in the control and intervention groups, respectively. The rate of missed doses was decreased by 90.1% for participants in the intervention group and 61.1% for those in the control group. We applied logistic regression analysis and determined that participants in the intervention group had a 3.2-fold higher probability of having a decrease in delayed doses compared with participants in the control group. Participants in the intervention group also showed a 2.2-fold higher probability of having a decrease in missed doses compared with participants in the control group. CONCLUSIONS: Use of SMS significantly affected the rates of taking medicine on schedule. Therefore, daily SMS could be useful for reminding patients to take their medicine on schedule.

Effect of the milling solution on lead stabilization in municipal solid waste incinerator fly ash during the milling processes.

The wet milling process had been found to effectively stabilize lead in fly ash. This study adopts this method and looks at the effect of different milling solutions to improve the efficiency of lead stabilization. Different milling solutions (water, phosphoric acid and ethanol) and different milling times (1, 24, 48 and 96 h) were selected as parameters. Since lead oxide can be identified by XRD in this experiment's samples, 5% lead oxide was added to the extracted mixed fly ash to make instrumental analysis easier. The experimental results indicate that the effect of stabilization of lead after milling could exceed 96%. During milling with water, considerable lead leached into the water in the initial stage (1 h) of the process, but a stable level was reached as the milling time increased. After milling with ethanol and 0.2 M phosphoric acids, the efficiency could exceed 93% after 1 h of milling time. The results of the sequential extraction procedure (SEP) results show that the residual fraction could be increased from 8.93% to 56.16% when a 0.2 M phosphoric acid solution was used. Clearly the choice of an appropriate milling solution can enhance lead stabilization in the fly ash.

Effects of wet ball milling on lead stabilization and particle size variation in municipal solid waste incinerator fly ash.

Water-extracted municipal solid waste incinerator (MSWI) fly ash was treated by a process of wet ball milling, using desalinated water as the milling solution. We investigated the influence of the milling process on the partitioning and leaching characteristics of lead (Pb) and the particle size distribution. The results show that 93.11% of the Pb was partitioned into the milled ash, 2.60% to the milling balls, and 0.17% to the inner surface of the milling jar, while amounts lower than the detection limit remained in the milled solution. As tested by the toxicity characteristic leaching procedure (TCLP), the leaching of Pb was inhibited after short-term grinding (from 5.2 to 1.2mg/L after 1h of milling), and further reduced by about 96% after 96h of ball milling. The mobility of the heavy metal was analyzed after a sequential extraction procedure. The results also show that Pb tended to become more stable after milling. The size distribution of particles was analyzed by a laser particle diameter analyzer and their morphology during grinding was observed using scanning electron microscopy. The median size of the fly ash decreased significantly from 36 to 5 microm after 0.5h of milling, but then only slightly, from 5 to 2 microm, with further milling from 0.5 to 96 h, due to the concurrent actions of fragmentation and/or agglomeration. The reason for the stabilization of Pb by ball milling was probably that Pb was sealed in the milled fly ash during the fragmentation and agglomeration of particles.