Mobile phone text-messaging to support treatment for people with type 2 diabetes in sub-Saharan Africa: a pragmatic individually randomised trial

Background

Treatment for patients with type 2 diabetes could be substantially improved in sub-Saharan Africa. Amongst the problems identified, failure to take medicines to treat diabetes regularly, is a major problem. Resources to identify and support patients who are not making best use of medicine in low and middle-income settings are scarce. Mobile phones are widely available in these settings including among people with diabetes and linked technologies such as SMS-text messaging, have shown promise in delivering low cost interventions efficiently.. However, evidence that these interventions will work when carried out at a larger scale, and of the extent to which they will improve health outcomes when added to usual care is limited.

Aims

The overall aim of this project was to test the effectiveness of sending short message service (SMS) texts in improving health outcomes and supporting medication adherence in patients with type 2 diabetes in the context of implementing a low-cost, mobile-health communication infrastructure in an operational setting.

Project plan

The primary outcome was the Change in HbA1c and the proportion of patients collecting >= 80% of their agreed diabetes related medication. HbA1c will be measured using International Federation of Clinical Chemistry calibrated analysers linked to a quality assurance scheme.

Secondary clinical outcomes were change in systolic blood pressure, proportion of participants reaching treatment goals, self-reported measures of health status, self reported medication taking, and satisfaction with care. The team planned to use the EuroQol 5-Dimension, 3 Level (EQ-5D) questionnaire, and a locally adapted questionnaire to establish satisfaction with treatment and delivery of treatment.

Publications and output

GACD have published an end-of-programme report providing a comprehensive summary of the programme and outcomes.

Funding organisations

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