Why SMS Still Belongs in Digital Trials

It is easy to overlook SMS when building a digital trial. Compared to mobile apps and web platforms, it can feel outdated. There is no rich interface. No video support. No interactive forms.

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But SMS still plays a valuable role in keeping participants engaged and informed, especially in trials where not everyone is comfortable with apps or has consistent access to Wi-Fi.

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The first advantage is reach. Almost every mobile phone can receive a text message, regardless of age or operating system. For participants who do not want to download another app, or who forget their login credentials, a text message can be a reliable and direct line of communication.

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SMS also tends to be read. Unlike emails, which can get lost in crowded inboxes, text messages are usually seen quickly. That makes them well-suited to reminders, time-sensitive updates and check-in nudges.

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This is especially useful in studies involving older adults, rural populations or participants who might not regularly use smartphones for anything beyond calls and texts.

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A few examples where SMS still fits well:

• Sending reminders about appointments or diary entries
• Providing links to surveys or eConsent documents
• Notifying participants when a new task is available in the app
• Following up after missed data entries with a simple “still with us?”

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Some trials use SMS as a backup option rather than a primary method. That can work too. Having a fallback in place means that participants who lose access to the main app or portal can still be reached.

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Of course, SMS has limits. It should not be used to collect sensitive data, and it is not ideal for anything that requires formatting or security. But when paired with other tools, it can provide a helpful bridge that keeps participants from drifting away.

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The key is to treat it as part of the engagement toolkit, not an afterthought. Simple, well-timed messages can reinforce a sense of connection and make a digital study feel more human. And in the end, that is what keeps people involved.

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