Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial
| العنوان: | Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial |
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| المؤلفون: | Hazel Namadingo, Sara Cooper, Jonathan Ngoma, Bruno Pauly, L-M Yu, Kirsten Bobrow, Amelia C. Crampin, Shane A. Norris, Lionel Tarassenko, Emmanuelle Daviaud, Moffat J. Nyirenda, Natalie Leon, John Prince, Nicola Williams, David Springer, Andrew Farmer, Enita Phiri, Naomi S. Levitt, Donnela Besada |
| المساهمون: | Department of Medicine, Faculty of Health Sciences |
| المصدر: | BMC Public Health BMC Public Health, Vol 21, Iss 1, Pp 1-14 (2021) |
| بيانات النشر: | BioMed Central, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Randomised trial, Type 2 diabetes, Medication Adherence, law.invention, South Africa, Randomized controlled trial, law, Diabetes mellitus, Epidemiology, medicine, Humans, Text Messaging, Sub-Saharan Africa, business.industry, Public health, Public Health, Environmental and Occupational Health, medicine.disease, Blood pressure, Diabetes Mellitus, Type 2, Adherence, Relative risk, Physical therapy, SMS text-messages, Biostatistics, Public aspects of medicine, RA1-1270, business, Digital health, Cell Phone, Research Article |
| الوصف: | Background Failure to take medicines for diabetes as prescribed contributes to poor outcomes from the condition. Mobile phones are ubiquitous and short message service (SMS) texts have shown promise as a low-cost intervention. We tested the effectiveness of SMS-text messaging in improving outcomes in adults with type 2 diabetes. Methods StAR2D was a 12-month two-arm randomised trial of SMS-text messaging and usual care in Cape Town, South Africa and Lilongwe, Malawi. Messages used behaviour change theory and were developed with patients and staff. The intervention group received four messages each week. The primary outcome was change in HbA1c. Secondary outcomes were the proportion of patients who collected > 80% medication and changes in systolic blood pressure, lipids, cardiovascular risk, and the proportion of the participants reaching treatment goals. Results The trial took place between 1 October, 2016 and 1 October 2018, 1186 participants were randomised to intervention (593) and control (593) groups. 91% of participants completed follow-up. There was a reduction in HbA1c (DCCT) in both groups but not in mean change (95% CI) between groups (− 0.08% (− 0.31 to 0.16) (IFCC − 0.82 mmol/mol (− 3.44 to 1.79). There was a small but not significant increase in the proportions of participants likely to have collected 80% or more of medication (Relative risk 1.11 (0.84 to 1.47; P = 0.47). There was a significant difference between groups in change in systolic blood pressure from baseline of 3.46 mmHg (1.48 to 5.44, P = 0.001) in favour of the intervention group. The between group difference in change in 10-year risk of coronary heart disease was − 0.71% (− 1.46 to 0.04, P = 0.064). The proportion of participants meeting treatment goals in the intervention group was 36.0% and in the control group 26.8% (Relative risk 1.36 (1.13 to 1.63, P = 0.001). Participants reported many challenges to adherence despite finding messages acceptable and useful. Conclusions Whilst SMS text messages do not lead to improved glycaemia in these low-resource settings there appeared to be an impact on blood pressure and achievement of treatment goals but the mechanisms for this are unclear. Text messages alone, may be unsuccessful unless accompanied by health system strengthening and other forms of self-management support for type 2 diabetes. Trial registration Trial registration: ISRCTN, ISRCTN70768808. Registered 1 July 2015, http://www.isrctn.com/I ISRCTN70768808. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1471-2458 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cab70e6782d64b4d98c79aab4223c158 http://europepmc.org/articles/PMC8529732 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....cab70e6782d64b4d98c79aab4223c158 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712458 |
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