Efficacy of Mobile Phone Short Message Service (SMS) Reminders on Malaria Treatment Adherence and Day 3 Post-Treatment Reviews (SMS-RES-MAL) in Kenya: A Study Protocol.

Journal of clinical trials Pub Date : 2019-06-25 Epub Date: 2015-03-23 DOI:10.4172/2167-0870.1000217
Ambrose O Talisuna, Dejan Zurovac, Sophie Githinji, Amos Oburu, Josephine Malinga, Andrew Nyandigisi, Caroline Oh Jones, Robert W Snow
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引用次数: 6

Abstract

Background: Mobile phone short messaging services (SMS) have been investigated in health information reporting, provider performance, drug and diagnostic stock management and patient adherence to treatment for chronic diseases. However, their potential role in improving patients' adherence to malaria treatment and day 3 post treatment reviews remains unclear.

Methods/design: A "proof of concept" open label randomised controlled trial will be conducted at four sites in Western Kenya. Principal research questions are: 1) Can mobile phone SMS reminders improve patient adherence to malaria treatment? 2) Can mobile phone SMS reminders improve day 3 post treatment reviews? Eligible caregivers (n=1000 per arm) of children under five years old with uncomplicated malaria will be randomly assigned (one to one) to: a) the current standard of care (provider counselling and health education); and b) the current standard of care plus SMS reminders. Within each arm, caregivers will be further randomized to three different categories. In categories 1 and 2, 300 caregivers per arm per category will be visited at home on day 1 and 2 of follow up respectively, to measure appropriate timing and adherence of the second Artemether-Lumefantrine (AL) dose and doses 3 and 4. Further, caregivers in categories 1 and 2 will be required to come to the health facility for the day 3 post treatment reviews. Finally, in category 3, 400 caregivers per arm will be visited at home on day 3 to measure adherence for the full AL course. Each category will be visited at home only once to avoid biases in the measures of adherence as a result of home consultations. Primary outcomes will be adherence to the full AL course (category 3), as well as, the proportion of patients reporting back for day 3 post treatment reviews (categories 1 and 2). The primary analysis will be intention-to-treat. Costs of the intervention will be measured over the period of the intervention, and a cost-effectiveness ratio will be estimated.

Discussion: If successful, evidence from this trial could improve malaria treatment adherence and offer pragmatic approaches for antimalarial drug resistance surveillance and risk mitigation in Africa.

Current controlled trials: ISRCTN39512726.

Abstract Image

Abstract Image

肯尼亚手机短信服务(SMS)提醒疟疾治疗依从性和治疗后第3天审查(SMS- res - mal)的有效性:一项研究方案。
背景:移动电话短信服务(SMS)在健康信息报告、提供者绩效、药物和诊断库存管理以及慢性病患者对治疗的依从性方面进行了调查。然而,它们在提高患者对疟疾治疗的依从性和治疗后第3天审查方面的潜在作用尚不清楚。方法/设计:一项“概念验证”的开放标签随机对照试验将在肯尼亚西部的四个地点进行。主要研究问题是:1)手机短信提醒能否提高患者对疟疾治疗的依从性?2)手机短信提醒是否能改善第3天的治疗后评价?符合条件的五岁以下无并发症疟疾儿童护理人员(每组n=1000人)将被随机分配(一对一)到:a)目前的护理标准(提供者咨询和健康教育);b)目前的护理标准加上短信提醒。在每组中,护理人员将进一步随机分为三个不同的类别。在第1类和第2类中,将分别在随访的第1天和第2天对每个类别的每个手臂的300名护理人员进行家访,以测量第二剂量、剂量3和剂量4的适当时间和依从性。此外,第1类和第2类护理人员将被要求在治疗复查后的第3天前往卫生机构。最后,在第3400个类别中,每只手臂的护理人员将在第3天在家访问,以测量整个人工智能过程的依从性。每个类别将只在家中进行一次访问,以避免由于家庭咨询而导致依从性措施的偏差。主要结局将是整个AL疗程的依从性(第3类),以及治疗后第3天报告的患者比例(第1类和第2类)。主要分析将是治疗意向。将在干预期间衡量干预的成本,并估计成本-效果比。讨论:如果成功,该试验的证据可以改善疟疾治疗依从性,并为非洲的抗疟药物耐药性监测和风险缓解提供务实的方法。当前对照试验:ISRCTN39512726。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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