Malaria
Conditions
Keywords
Malaria, ACTs
Brief summary
A randomized controlled trial was conducted to assess the effectiveness of text reminders sent to ACT users through an automated text messaging system short-message-system. Study hypothesis: text message reminders increase adherence
Detailed description
A randomized controlled trial was conducted to assess the effectiveness of text reminders sent to ACT users through an automated text messaging system short-message-system. Patients were enrolled at clinics and pharmacies upon receipt of ACTs and enrolled in the automated system for 3 days.
Interventions
BEHAVIORALText message reminders
Patients in the two treatment arms receive six short text message reminders within 60 hours of treatment initiation at 12 hour intervals to remind them to take their malaria medication as prescribed.
Sponsors
Harvard School of Public Health (HSPH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
-subjects acquiring ACTs in Tamale, Ghana
Exclusion criteria
* subjects acquiring ACTs for non household members * subjects under the age of 18 * subjects without access to cell phones * subjects living more than 30 minutes from pickup location
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported Adherence to Artemisinin-combination Therapy (ACT) Treatment | 70 hours | Percentage of participants completing full ACT treatment regimen 70 hours after treatment initiation. Subjects were visited at home, and asked to report when each of the prescribed six doses were taken. Adherence was defined as the (self-reported) completion of all six doses. |
Countries
Ghana
Participant flow
Recruitment details
Subjects were recruited at all private and public facilities distributing Artemisinin-combination Therapies (ACTs).
Pre-assignment details
Only subjects from the Tamale area with cell phones were included.
Participants by arm
| Arm | Count |
|---|---|
| Control Patients in this group received only a generic malaria information message (use bed nets) at the end of the study. | 554 |
| Short Message Patients in this arm receive six short text message reminders within 60 hours of treatment initiation at 12 hour intervals. | 277 |
| Long Message Patients in this arm receive six long text message reminders (reminders including justification for why patients should finish medication) within 60 hours of treatment initiation at 12 hour intervals. | 309 |
| Total | 1,140 |
Baseline characteristics
| Characteristic | Short Message | Long Message | Control | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 105 Participants | 111 Participants | 166 Participants | 382 Participants |
| Age, Categorical >=65 years | 14 Participants | 32 Participants | 46 Participants | 92 Participants |
| Age, Categorical Between 18 and 65 years | 158 Participants | 166 Participants | 342 Participants | 666 Participants |
| Age, Continuous | 23 years STANDARD_DEVIATION 17.1 | 23.8 years STANDARD_DEVIATION 17.8 | 25.3 years STANDARD_DEVIATION 17.7 | 24.3 years STANDARD_DEVIATION 17.6 |
| Region of Enrollment Ghana | 277 participants | 309 participants | 554 participants | 1140 participants |
| Sex: Female, Male Female | 152 Participants | 180 Participants | 302 Participants | 634 Participants |
| Sex: Female, Male Male | 125 Participants | 129 Participants | 252 Participants | 506 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 554 | 0 / 277 | 0 / 309 |
| serious Total, serious adverse events | 0 / 554 | 0 / 277 | 0 / 309 |
Outcome results
Primary
Self-reported Adherence to Artemisinin-combination Therapy (ACT) Treatment
Percentage of participants completing full ACT treatment regimen 70 hours after treatment initiation. Subjects were visited at home, and asked to report when each of the prescribed six doses were taken. Adherence was defined as the (self-reported) completion of all six doses.
Time frame: 70 hours
Population: The number of subjects analyzed is smaller than the number of subjects enrolled due to missing data on adherence. A total of 30 observations were lost due to missing information on adherence - 16 in the control group, 9 in the short message group, and 5 in the long message group.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Control | Self-reported Adherence to Artemisinin-combination Therapy (ACT) Treatment | 61.5 percentage of participants |
| Short Message | Self-reported Adherence to Artemisinin-combination Therapy (ACT) Treatment | 69.0 percentage of participants |
| Long Message | Self-reported Adherence to Artemisinin-combination Therapy (ACT) Treatment | 64.1 percentage of participants |