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12-Nov-2016 19:01

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.

The results will inform implementation and wider use of mobile phone based interventions for health care delivery in a low-resource setting. Long-term blood pressure control requires integrating medication taking into daily life to support adherence and persisting with treatment.

A wide range of different strategies and interventions has been used to support patients in adhering to treatment plans, although results are not consistent [].

The SMS Text-message Adherence suppo Rt trial (St AR) 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.

Some of the texts are personalised (include first or chosen name).

The intervention is compliant with South African regulations and ethics, and regulatory guidelines on good SMS-practice [In addition to the intervention provided to participants allocated to the informational SMS text-message group, participants in the interactive SMS text-message group can also respond to texts and send messages to the clinic.

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Examples of the type of SMS text-messages sent to participants allocated to the two intervention arms are shown in Table Participants allocated to the usual care group only receive the SMS-texts sent to all trial participants.

One strategy that may facilitate such support is the integration of a patient’s mobile (or cellular) phone in the process of health care delivery.

Globally, the mobile phone has become the preferred tool for communication and access to information bringing together communication and computing technology.

Some but not all trials suggest that SMS text-message reminders may improve clinic attendance, retention in care, and self-reported medication adherence [].

Two trials in Spain with short follow-up periods have explored the efficacy of SMS-based interventions for people with hypertension to improve treatment compliance and blood pressure control.These messages are sent no more frequently than one SMS text-message every four weeks.