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Table 3 Characteristics studies included in the review

From: Does phone messaging improves tuberculosis treatment success? A systematic review and meta-analysis

Study ID

Belknap, et al, 2017 [49]

Setting

USA, Spain, Hong Kong and South Africa

Methods

A randomized clinical trial

Participants

Adults (aged ≥18 years) LTBI cases

Sample size

Overall, 1002 LTBI case were participated

Interventions

A one-way weekly text-based treatment reminder

Outcomes

Treatment completion was 87% in DOTS, 74% in self-administration and 76 in self-administration plus SMS reminders groups.

Limitations

All participants were not randomly assigned to receive SMS reminders

Study ID

Barclay, 2009 [46]

Setting

South Africa

Methods

A single arm interventional study from July, 2006 to April, 2007

Participants

Tuberculosis patients at three clinics in the Cape Town

Sample size

155 patients

Interventions

Text messaging using SIMpill for 10 months

Outcomes

Drug adherence stabilized between 86 and 92% with a treatment success rate of 94% after patients used the SIMpill for 10 months.

Limitations

No comparator groups

Study ID

bridges.org, 2005 [50]

Setting

South Africa

Methods

A single arm trial with historical control

Participants

All adults with pulmonary and extra pulmonary TB were included in the study

Sample size

About 221 TB patients were followed in single arm design

Interventions

A one-way text-based daily phone reminder for anti-TB medication for six and eight months

Outcomes

Treatment success rate was 73% in trial and 69% in the latest statistics available for the City of Cape Town’s TB Control Program

Limitations

No inferential statistics in treatment success rates, due to limited sample size

Study ID

Fang X.H. et al, 2017 [51]

Setting

China

Methods

A Randomized controlled trial was conducted from December 1, 2014 to 31, 2015

Participants

All pulmonary TB patients from six districts

Sample size

Overall 350 (160 in intervention and 190 in control groups)

Interventions

A one-way text-based daily phone reminder for anti-TB medication for six months

Outcomes

The treatment completion rate in SMS group (96.25%) was significantly higher than that in the control group (86.84%), p-0.002

Limitations

Study included few predictor variables and generalizability restricted to one province

Study ID

Farooqi et’al, 2015 [44]

Setting

Pakistan

Methods

Randomized controlled trial was conducted from June 2014 to June 2015

Participants

Patients enrolled for anti-TB drugs were distributed in intervention and control groups

Sample size

148 TB patients

Interventions

A one-way text and graphic reminders sent daily to intervention group for two months

Outcomes

Primary outcome was default, defined as not taking medicine for two consecutive months. TB treatment success rate was 96.9% in intervention group and 94.26% in controls, p-0.983

Limitations

Didn’t assess background knowledge of participants

Study ID

Johnston, et al, 2018 [52]

Setting

Canada

Methods

A parallel, randomized controlled trial

Participants

Adults initiating LTBI therapy between June 2012 and September 2015

Sample size

Overall, the study enrolled 358 participants (170 in intervention and 188 in control arms)

Interventions

An interactive (two-way) text and phone call message service for LTBI adherence.

Outcomes

Treatment completion was 79% in intervention and 82% in control groups with RR 0.97; p = 0.550

Limitations

Outcome influenced by intensive monitoring schedule of the standard care

Study ID

Georges B. et al, 2018 [53]

Setting

Cameroon

Methods

A randomized controlled trial conducted between February 2013 and April 2014

Participants

Adults (>  18 years) and newly diagnosed PTB patients

Sample size

Two hundred seventy-nine participants; 137 in intervention 142 in control groups

Interventions

A one-way daily text-based reminder and motivational messages for six months

Outcomes

At five months, treatment success was 81% in intervention and 75% in control groups with OR = 1.45; p = 0.203.

Limitations

High attrition of participants

Study ID

Hermans SM. et al, 2017 [54]

Setting

Uganda

Methods

Quasi-experimental study design held between November 2010 and October 2011

Participants

Adult, literate, HIV/TB patients access with mobile phone

Sample size

Overall 485 (183 in intervention and 302 in control groups) followed up.

Interventions

An interactive (two way) text-based medication and appointment reminder, and educational messages using a total of 8 SMSs per 2 weeks for two months

Outcomes

After 8 weeks intervention, successful completion of treatment was 93% in intervention and 89% in control groups, p-0.43.

Limitations

Use of pre-intervention control group prone to temporal changes could influence outcomes

Study ID

Kumboyono, 2017 [48]

Setting

Indonesia

Methods

A post-test-only controlled-group design

Participants

Adult TB patients enrolled on treatment

Sample size

45 TB patients enrolled on treatment

Interventions

A text-based phone messaging to motivate patients

Outcomes

There was no difference in treatment compliance between the SMS and control groups with a p-0.059 of Fisher’s Exact test.

Limitations

Limited sample size

Study ID

Kunawararak et’al, 2011 [41]

Setting

Thailand

Methods

A two arm RCT between April 2008 and December 2009

Participants

New sputum smear positive pulmonary TB patients (both non-MDR-TB and MDR-TB) Patients aged > 15 years

Sample size

98 (60 Non-MDR and 38 MDR) TB patients

Interventions

An interactive daily phone call reminder for six and eighteen months

Outcomes

Treatment success Rate (TSR) was significantly higher in intervention group (100%) than control (96.7%) in non-MDR-TB, (p-0.047).

Limitations

Limited sample size

Study ID

Liu et’al, 2012 [45]

Setting

China

Methods

A pragmatic cluster-randomized trial in 36 districts. From 1 June 2011 to 7 March 2012, 4292 TB patients were enrolled across the clusters.

Participants

New pulmonary TB patients, starting on standard 6-month short-course chemotherapy

Sample size

4292 TB patients

Interventions

An interactive daily text messages to reminder medications for six months

Outcomes

TB treatment success was 96.1% in SMS groups, 91.4% in control groups, with p-0.084

Limitations

Over-estimation of poor adherence

Study ID

Mohammed et’al, 2013 [43]

Setting

Pakistan

Methods

A two-arm, randomized controlled trial in Karachi, Pakistan. Individual participants were randomized to either SMS or the control group.

Participants

Newly-diagnosed patients with smear or bacteriologically positive pulmonary tuberculosis who were on treatment for less than two weeks; ≥15 years; reported having access to a mobile phone; and intended to live in Karachi throughout treatment were eligible. The study enrolled 2207 participants, with 1110 randomized to SMS and 1097 to the control group.

Sample size

2207 TB patients

Interventions

An interactive daily text pill reminder for six months and participants respond with SMS or missed calls after taking medication. Up to 3 SMSs sent for non-respondents a day.

Outcomes

There was no significant difference between the SMS or control groups for treatment success (719 or 83% vs. 903 or 83%, respectively, p = 0.782).

Limitations

Lack of an objective tool to measure adherence

Study ID

Narasimhan et’al, 2013 [47]

Setting

India

Methods

Single arm interventional study

Participants

TB patients seeking care from the DOTS centers

Sample size

104 patients recruited, 100 patients were followed until end of treatment

Interventions

Text and/or voice call reminder enabled treatment adherence support system

Outcomes

A voice call reminder system could improve patients adherence to TB drugs

Limitations

The effect size of the intervention was not determined

Study ID

Sarah I. et al, 2013 [42]

Setting

Argentina

Methods

A randomized 1:1 allocation

Participants

Patients newly diagnosed with TB who were ≥ 18 years, and had mobile-phone access

Sample size

38 TB patients (18 in intervention and 19 in control)

Interventions

An interactive bi-weekly text-based educational messages to patients to adhere to medication for the first 2 months of treatment

Outcomes

Treatment success was 17/18 in intervention arm and 17/19 in control arm.

Limitations

Baseline knowledge not addressed; use self-reporting that may bias the outcome