Table 2 Characteristics of included studies
Study ID | Bridges.org [37] |
|---|---|
Methods | The evaluation used both qualitative and quantitative data collection methods. Structured interviews using a questionnaire were conducted among patients and staff. Additional information was collected from patient records, background documents and reports and clinic visits. |
Participants | Patients, clinic staff, TB experts and managers at the City of Cape Town Health Directorate. |
Interventions | Daily SMS reminders were used to remind patients who self-administer their medication (i.e. not on DOTS) to take their drugs. |
Outcomes | 1) Health Outcomes serve as a proxy for TB treatment adherence |
On Cue Compliance service (from 221 patients with records available): | |
Cure rate = 62.35% | |
Completion rate = 10.59 | |
Treatment success rate = 72.94% | |
Clinic-based DOTS (in particular new smear-positive TB patients in the third quarter of 2003): | |
Cure rate = 66.4% | |
Completion rate = 3.0% | |
Treatment success rate = 69.4% | |
Health outcomes between groups were similar. | |
2) Patient satisfaction with the SMS intervention | |
Notes | |
Study ID | Broomhead[38] |
Methods | A retrospective analysis comparing the costs and health outcomes of the DOTS-SIMPill cohort with DOTs-only controls. |
Participants | 24 New smear-positive TB patients who presented to Betty Gaetsewe Clinic and commenced the 6-month treatment on first line and anti-TB medication enrolled for SMS based medical adherence support (MAS) pilot in 2005 and 96 DOTs-only control patients presenting for the months during the pilot was running. |
Frequency matching was used to match MAS pilot participants with controls in a 4:1 ratio. Matching was on TB treatment, local clinic, gender and age. | |
Interventions | Intervention: |
MAS system. It consists of a device that attaches to the standard pill bottle or blister pack and sends an SMS every time the patient opens the bottle to a Web-base application. This is taken as a proxy for TB treatment adherence. | |
Control: | |
DOTS-only controls | |
Outcomes | Health outcomes (i.e. smear conversion rate and TB cure rate) served as a proxy for TB treatment adherence |
MAS group: | |
Smear conversion rate = 62.5% | |
TB cure rate = 75.0% | |
Control group: | |
Smear conversion rate = 38.4% | |
TB cure rate = 32.3% | |
Both the smear conversion rate and TB cure rate were significantly higher for the MAS group compared with the control group | |
Smear conversion rate: RR 1.62 (95% CI 1.09-2.42) | |
TB cure rate: RR 2.32 (95% CI 1.60 – 3.36) | |
Notes | |
Study ID | Iribarren[40] |
Methods | A parallel design randomized control pilot study |
Participants | 37 newly diagnosed TB patients (18 in the intervention group and 19 in the control group) |
Interventions | Intervention: |
Standard Care plus a SMS-based intervention which included instructing patients to “text in” after self-administration of medication; reminders/check-in when patient did not “text in”; receipt of bi-weekly SMS education messages; and the option to consult during the first two months intensive treatment phase. | |
FrontlineSMS network was employed. | |
Control: | |
Self-administration of TB treatment (standard of care) | |
Outcomes | Of the intervention group, 77% (22%-100%) notified (i.e. self report via text message) that they took their medication over a 60 day period. The control group was asked to complete medication calendars over the same period but only 53% of them returned the calendars. We found that the SMS intervention did not statistically improve adherence to TB treatment (RR 1.49 [95% CI 0.90-2.42]). |
Notes | Additional information obtained from the primary author. The full article for the corresponding conference abstract is yet to be published. |
Study ID | Owiti[39] |
Methods | A feasibility pilot study |
Participants | 187 TB patients with mobile phones |
Interventions | Intervention: |
Receiving text messages in Ki-Swahili which were delivered one day prior to the patients’ clinic appointment | |
Control: | |
Not receiving text messages (due to technical reasons) | |
Clinic attendance on scheduled days | |
Outcomes | • Received at least one text: 101/150 |
• Did not receive a text (due to technical reasons): 16/37 | |
RR 1.56 [95% CI 1.06-2.29]; p-value <0.0007. | |
Notes | • We noted an error in the table presented by the authors which occurred in the rows for males and females, in particular, the cell containing data for males who did not receive a text message were transposed with that containing data for females who received at least one text message. However, we did not use that information. Instead, we used the data in the total row, that was corroborated with the information in the abstract text. |
• The full article for the corresponding conference abstract is yet to be published (Dr P. Owti, personal communication) |