Poor adherence to antipsychotic treatment is a well-recognized challenge among patients with schizophrenia and is associated with increased morbidity and consumption of health care resources.

We evaluated the effect of daily Short Message Service (SMS) reminders on patients’ adherence to antipsychotic medication in schizophrenia.

Clinically stabilized outpatients with schizophrenia and considered to be poor adherent (at least one affirmative answer of Morisky-Green questionnaire -MAQ) to antipsychotic monotherapy were included in a multicenter, randomized, open-label, controlled trial. Participants were randomized to receive a daily SMS reminder on their cell phone to take their medication during 3 months or current standard of care. The primary outcome measure was improvement in adherence rate (mean MAQ score) after 3 months.

254 patients were analysed, 66.5% men. Mean age: 39.7 years (SD = 11.03). Baseline socio-demographic and clinical characteristics were similar between the two groups. No significant differences in baseline mean MAQ scores were observed between groups (2.23, SD = 0.94 and 2.23, SD = 0.85, respectively).

At month 3, mean MAQ score in the intervention group was 1.2 and 1.53 in the control group. Absolute difference in mean adherence rate between groups was −0.33 (95%CI −0.62, −0.03; p = 0.03). Largest change from baseline was observed in question 4 of the questionnaire “When you feel better, do you sometimes stop taking your medicine?” (percentage of affirmative answers in the SMS group vs control was 45% and 59%, respectively, p = 0.02).

SMS reminders, added to standard interventions for schizophrenia management, may help many patients to improve adherence to antipsychotic medication.