![]() ![]() Oral consent was solicited instead of written consent, as our sample was a low-literate population. Enrolment continued until the predetermined sample size was met.Įligible participants were consented using an oral consent form, a copy of which was given to the participant. To minimize spillovers, patients with another household member in the study were ineligible. To allow Zindagi SMS to help establish habits early, participants had to be on treatment for less than two weeks. To be eligible, participants had to be newly diagnosed with smear or bacteriologically positive pulmonary tuberculosis 15 years of age or older report having access to a mobile phone and intend to live in Karachi throughout treatment. Participants were recruited into the randomized controlled trial through a large tertiary center (the Indus Hospital), nine public facilities, and a network of private General Practitioner (GP) clinics and private laboratories in Karachi. Our effectiveness trial gauged the impact of a two-way interactive SMS medication reminder system (Zindagi SMS) on the treatment success of people with drug-sensitive tuberculosis. Recently, a limited cluster randomized trial in China found that, while medication monitor reminders led to improved drug compliance for tuberculosis patients, daily two-way SMS reminders did not. While there is considerable interest in the potential of mobile phone-based interventions to improve tuberculosis treatment adherence, rigorous evidence on their impact is limited. A more recent study of interactive automated voice reminders and pictorial messages in India, found no impact on adherence to ART. Meta-analysis that combines two positive trials in Kenya and one null result from Cameroon found an overall positive impact of weekly Short Message Service (SMS, or text message) reminders. The most rigorous trials evaluating mobile phone-use for treatment compliance in developing countries exist for adherence to antiretroviral therapy (ART) for people living with Human Immunodeficiency Virus (HIV). Most trials are inadequately designed, insufficiently powered, or are restricted to high-income countries. Mobile phone-based interventions to improve medication adherence have been adopted for many diseases, with mixed results. The rapid uptake of mobile phones in low- and middle-income countries has provided public-health programs unprecedented access to patients. However, evidence for the effectiveness of this method is inconclusive. The World Health Organization recommends directly observed therapy to promote adherence, where a pre-assigned treatment supporter watches each patient take his/her daily medication. Failure to adhere to treatment can result in continued transmission, the development of multidrug-resistant tuberculosis, or death. Treatment for drug-sensitive tuberculosis lasts six to eight months and can result in difficult side effects. Tuberculosis is the second-leading cause of death from infectious diseases globally, with nine million people infected and 1.5 million deaths in 2013. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. įunding: This study was funded by the International Initiative for Impact Evaluation ( ), grant number OW 1.48. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data can be accessed at. Received: Accepted: AugPublished: November 1, 2016Ĭopyright: © 2016 Mohammed et al. PLoS ONE 11(11):Įditor: Lei Gao, Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA Citation: Mohammed S, Glennerster R, Khan AJ (2016) Impact of a Daily SMS Medication Reminder System on Tuberculosis Treatment Outcomes: A Randomized Controlled Trial. ![]()
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