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

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dc.contributor.authorBobrow, Kirsty
dc.contributor.authorBrennan, Thomas
dc.contributor.authorSpringer, David
dc.contributor.authorLevitt, Naomi S
dc.contributor.authorRayner, Brian
dc.contributor.authorNamane, Mosedi
dc.contributor.authorYu, Ly-Mee
dc.contributor.authorTarassenko, Lionel
dc.contributor.authorFarmer, Andrew
dc.date.accessioned2015-07-30T03:54:15Z
dc.date.available2015-07-30T03:54:15Z
dc.date.issued2014-01-11
dc.date.updated2015-04-08T18:02:21Z
dc.description.abstractAbstract 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. Trial registration NCT02019823
dc.identifier.apacitationBobrow, K., Brennan, T., Springer, D., Levitt, N. S., Rayner, B., Namane, M., ... Farmer, A. (2014). 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. <i>BMC Public Health</i>, http://hdl.handle.net/11427/13585en_ZA
dc.identifier.chicagocitationBobrow, Kirsty, Thomas Brennan, David Springer, Naomi S Levitt, Brian Rayner, Mosedi Namane, Ly-Mee Yu, Lionel Tarassenko, and Andrew Farmer "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." <i>BMC Public Health</i> (2014) http://hdl.handle.net/11427/13585en_ZA
dc.identifier.citationBobrow, K., Brennan, T., Springer, D., Levitt, N. S., Rayner, B., Namane, M., ... & Farmer, A. (2014). 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, 14(1), 28.
dc.identifier.ris TY - Journal Article AU - Bobrow, Kirsty AU - Brennan, Thomas AU - Springer, David AU - Levitt, Naomi S AU - Rayner, Brian AU - Namane, Mosedi AU - Yu, Ly-Mee AU - Tarassenko, Lionel AU - Farmer, Andrew AB - Abstract 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. Trial registration NCT02019823 DA - 2014-01-11 DB - OpenUCT DO - 10.1186/1471-2458-14-28 DP - University of Cape Town J1 - BMC Public Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/13585 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13585
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2458-14-28
dc.identifier.vancouvercitationBobrow K, Brennan T, Springer D, Levitt NS, Rayner B, Namane M, et al. 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. 2014; http://hdl.handle.net/11427/13585.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDivision of Nephrology and Hypertensionen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License*
dc.rights.holderBobrow et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/2.0*
dc.sourceBMC Public Healthen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpublichealth/
dc.subject.othertext messaging interventionen_ZA
dc.subject.otherhypertensionen_ZA
dc.titleEfficacy of a text messaging (SMS) based intervention for adults with hypertension: protocol for the StAR (SMS Text-message Adherence suppoRt trial) randomised controlled trial
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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