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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Efficacy of a text messaging (SMS) based intervention for adults with hypertension: Protocol for the StAR (SMS Text-message Adherence suppoRt trial) randomised controlled trial
BMC Public Health, Volume 14, No. 1, Article 28, Year 2014
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Description
Background: Interventions to support people with hypertension in attending clinics and taking their medication have potential to improve outcomes, but delivery on a wide scale and at low cost is challenging. Some trials evaluating clinical interventions using short message service (SMS) text-messaging systems have shown important outcomes, although evidence is limited. We have developed a novel SMS system integrated with clinical care for use by people with hypertension in a low-resource setting. We aim to test the efficacy of the system in improving blood pressure control and treatment adherence compared to usual care. Methods/design: The SMS Text-message Adherence suppoRt trial (StAR) is a pragmatic individually randomised three-arm parallel group trial in adults treated for hypertension at a single primary care centre in Cape Town, South Africa. The intervention is a structured programme of clinic appointment, medication pick-up reminders, medication adherence support and hypertension-related education delivered remotely using an automated system with either informational or interactive SMS text-messages. Usual care is supplemented by infrequent non-hypertension related SMS text-messages. Participants are 1:1:1 individually randomised, to usual care or to one of the two active interventions using minimisation to dynamically adjust for gender, age, baseline systolic blood pressure, years with hypertension, and previous clinic attendance. The primary outcome is the change in mean systolic blood pressure at 12-month follow-up from baseline measured with research staff blinded to trial allocation. Secondary outcomes include the proportion of patients with 80% or more of days medication available, proportion of participants achieving a systolic blood pressure less than 140 mmHg and a diastolic blood pressure less than 90 mmHg, hospital admissions, health status, retention in clinical care, satisfaction with treatment and care, and patient related quality of life. Anonymised demographic data are collected on non-participants. Discussion: The StAR trial uses a novel, low cost system based on widely available mobile phone technology to deliver the SMS-based intervention, manage communication with patients, and measure clinically relevant outcomes. The results will inform implementation and wider use of mobile phone based interventions for health care delivery in a low-resource setting. © 2014 Bobrow et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Bobrow, Kirsten L.
United Kingdom, Oxford
University of Oxford
United Kingdom, Oxford
University of Oxford Medical Sciences Division
South Africa, Observatory
Groote Schuur Hospital
Brennan, Thomas
United Kingdom, Oxford
University of Oxford
Springer, D.
United Kingdom, Oxford
University of Oxford
Levitt, Naomi S.
South Africa, Observatory
Groote Schuur Hospital
Rayner, Brian L.
South Africa, Observatory
Groote Schuur Hospital
Namane, Mosedi Keanetse
South Africa, Cape Town
Metro District Health Services
Yu, Ly Mee
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Tarassenko, Lionel
United Kingdom, Oxford
University of Oxford
Farmer, Andrew J.
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Statistics
Citations: 78
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2458-14-28
e-ISSN:
14712458
Research Areas
Disability
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study
Study Locations
South Africa