SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial
Abstract Background In Cameroon, the National Tuberculosis Control Program that applies selective directly observed treatments faces difficulties in its implementation for a lack of resources, leading to only 65% of patients with sputum smear-positive pulmonary tuberculosis being cured after 6 month...
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-5502-x |
| _version_ | 1818499545497075712 |
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| author | Georges Bediang Beat Stoll Nadia Elia Jean-Louis Abena Antoine Geissbuhler |
| author_facet | Georges Bediang Beat Stoll Nadia Elia Jean-Louis Abena Antoine Geissbuhler |
| author_sort | Georges Bediang |
| collection | DOAJ |
| description | Abstract Background In Cameroon, the National Tuberculosis Control Program that applies selective directly observed treatments faces difficulties in its implementation for a lack of resources, leading to only 65% of patients with sputum smear-positive pulmonary tuberculosis being cured after 6 months of treatment. This study aimed to evaluate the effectiveness of daily Short Message Service reminders to increase adherence and the proportion of adult tuberculosis patients cured after 6 months of treatment. Methods A simple blinded, randomised controlled, multicentre study carried out in 12 Treatment and Diagnostic Centres of Yaoundé. The patients included were randomly assigned to two groups: patients in the intervention group received daily SMS reminders in addition to the usual treatment; those in the control group received the usual treatment only. The primary outcomes were the number and proportion of treatment success at 5 months, and the number and proportion of patients cured at 6 months. Data analysis was by intention to treat. Results Two hundred and seventy-nine participants were randomized into intervention group (n = 137) and control group (n = 142). At five months, there were 111 treatment success (81%) in the intervention group and 106 (74.6%) in the control group (OR = 1.45 [0.81, 2.56]; p = 0.203). At 6 months, there were 87 patients cured (63.5%) in the intervention group and 88 (62%) in the control group (OR = 1.06 [0.65, 1.73]; p = 0.791). The number of drop-outs at 6 months was 47 (34.3%) in intervention group, and 46 (32.4%) in the control group. 48.9% (23/47) and 39.1% (18/46) of these drop-outs were sputum-negative at 5 months. At three different appointments, there were no significant differences between the two groups in any secondary outcomes. Very high and similar satisfaction was found for general management of patients in both groups: 99.5 and 99.2% (p = 0.41). Conclusions Our study suggests that SMS reminders do not increase treatment success and cure proportions. However, the low proportion of patients cured at 6 month may be an underestimation due to a high dropout rate between the fifth and the sixth months of treatment. Future trials should focus on reducing the dropout rate. Trial registration The trial was registered on the Pan-African Clinical Trials Registry (PACTR201307000583416 of 22 July 2013) and the protocol was published. |
| first_indexed | 2024-12-10T20:30:59Z |
| format | Article |
| id | doaj.art-a2a6366a7b4647708c3acbbb46e32b9f |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T20:30:59Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-a2a6366a7b4647708c3acbbb46e32b9f2022-12-22T01:34:41ZengBMCBMC Public Health1471-24582018-05-0118111410.1186/s12889-018-5502-xSMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trialGeorges Bediang0Beat Stoll1Nadia Elia2Jean-Louis Abena3Antoine Geissbuhler4Faculty of Medicine and Biomedical Sciences, University of Yaoundé IGeneva Tumour Registry, Institute of Global Health, Faculty of Medicine, University of GenevaGeneva Tumour Registry, Institute of Global Health, Faculty of Medicine, University of GenevaNational Tuberculosis Control Program, Ministry of Public HealthDepartment of Radiology and Medical Informatics, Faculty of Medicine, University of GenevaAbstract Background In Cameroon, the National Tuberculosis Control Program that applies selective directly observed treatments faces difficulties in its implementation for a lack of resources, leading to only 65% of patients with sputum smear-positive pulmonary tuberculosis being cured after 6 months of treatment. This study aimed to evaluate the effectiveness of daily Short Message Service reminders to increase adherence and the proportion of adult tuberculosis patients cured after 6 months of treatment. Methods A simple blinded, randomised controlled, multicentre study carried out in 12 Treatment and Diagnostic Centres of Yaoundé. The patients included were randomly assigned to two groups: patients in the intervention group received daily SMS reminders in addition to the usual treatment; those in the control group received the usual treatment only. The primary outcomes were the number and proportion of treatment success at 5 months, and the number and proportion of patients cured at 6 months. Data analysis was by intention to treat. Results Two hundred and seventy-nine participants were randomized into intervention group (n = 137) and control group (n = 142). At five months, there were 111 treatment success (81%) in the intervention group and 106 (74.6%) in the control group (OR = 1.45 [0.81, 2.56]; p = 0.203). At 6 months, there were 87 patients cured (63.5%) in the intervention group and 88 (62%) in the control group (OR = 1.06 [0.65, 1.73]; p = 0.791). The number of drop-outs at 6 months was 47 (34.3%) in intervention group, and 46 (32.4%) in the control group. 48.9% (23/47) and 39.1% (18/46) of these drop-outs were sputum-negative at 5 months. At three different appointments, there were no significant differences between the two groups in any secondary outcomes. Very high and similar satisfaction was found for general management of patients in both groups: 99.5 and 99.2% (p = 0.41). Conclusions Our study suggests that SMS reminders do not increase treatment success and cure proportions. However, the low proportion of patients cured at 6 month may be an underestimation due to a high dropout rate between the fifth and the sixth months of treatment. Future trials should focus on reducing the dropout rate. Trial registration The trial was registered on the Pan-African Clinical Trials Registry (PACTR201307000583416 of 22 July 2013) and the protocol was published.http://link.springer.com/article/10.1186/s12889-018-5502-xSMS-remindersText messagingmHealthEffectivenessTuberculosisDeveloping countries |
| spellingShingle | Georges Bediang Beat Stoll Nadia Elia Jean-Louis Abena Antoine Geissbuhler SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial BMC Public Health SMS-reminders Text messaging mHealth Effectiveness Tuberculosis Developing countries |
| title | SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial |
| title_full | SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial |
| title_fullStr | SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial |
| title_full_unstemmed | SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial |
| title_short | SMS reminders to improve adherence and cure of tuberculosis patients in Cameroon (TB-SMS Cameroon): a randomised controlled trial |
| title_sort | sms reminders to improve adherence and cure of tuberculosis patients in cameroon tb sms cameroon a randomised controlled trial |
| topic | SMS-reminders Text messaging mHealth Effectiveness Tuberculosis Developing countries |
| url | http://link.springer.com/article/10.1186/s12889-018-5502-x |
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