The effect of mobile phone text-message reminders on Kenyan health workers' adherence to malaria treatment guidelines: a cluster randomised trial.
The effect of mobile phone text-message reminders on Kenyan health workers' adherence to malaria treatment guidelines: a cluster randomised trial.
复制标题
DOI：
10.1016/s0140-6736(11)60783-6
复制
发表时间：
2011-08-27
期刊：
影响因子：
168.9
通讯作者：
Snow, Robert W.
中科院分区：
文献类型：
--
作者：
Zurovac, Dejan;Sudoi, Raymond K.;Akhwale, Willis S.;Ndiritu, Moses;Hamer, Davidson H.;Rowe, Alexander K.;Snow, Robert W.
卫生工作者的疟疾病例管理做法往往与国家指导方针不同。我们评估了发送到卫生工作者移动的手机上的短信提醒是否可以改善和保持他们对肯尼亚门诊儿童疟疾治疗指南的依从性。从2009年3月6日至2010年5月31日，我们在肯尼亚沿海和西部11个地区的107个农村卫生设施进行了一项随机分组对照试验。通过计算机生成的序列，卫生机构被随机分配到干预组，其中所有卫生工作者在6个月内通过个人移动的手机接收有关疟疾病例管理的短信，或对照组，其中卫生工作者没有收到任何短信。卫生工作者对干预措施不知情，尽管患者不知道他们是否在干预或控制设施中。主要结果是正确的管理蒿甲醚-苯芴醇，定义为一个二分法的综合指标的治疗，配药，咨询任务与肯尼亚国家指导方针一致。主要分析是通过意向治疗进行的。该试验在当前对照试验中注册，ISRCTN 72328636。119名卫生工作者接受了干预。对2269名需要治疗的儿童（干预组1157名，对照组1112名）的病例管理实践进行了评估。意向性治疗分析显示，干预后即刻，正确的蒿甲醚-苯芴醇管理提高了23.7个百分点（95%CI 7.6 - 40.0; p= 0.004），6个月后提高了24.5个百分点（8.1 - 41.0; p= 0.003）。在资源有限的情况下，疟疾控制方案应考虑使用短信来改善卫生工作者的病例管理做法。Wellcome Trust。
Health workers' malaria case-management practices often differ from national guidelines. We assessed whether text-message reminders sent to health workers' mobile phones could improve and maintain their adherence to treatment guidelines for outpatient paediatric malaria in Kenya. From March 6, 2009, to May 31, 2010, we did a cluster-randomised controlled trial at 107 rural health facilities in 11 districts in coastal and western Kenya. With a computer-generated sequence, health facilities were randomly allocated to either the intervention group, in which all health workers received text messages on their personal mobile phones on malaria case-management for 6 months, or the control group, in which health workers did not receive any text messages. Health workers were not masked to the intervention, although patients were unaware of whether they were in an intervention or control facility. The primary outcome was correct management with artemether-lumefantrine, defined as a dichotomous composite indicator of treatment, dispensing, and counselling tasks concordant with Kenyan national guidelines. The primary analysis was by intention to treat. The trial is registered with Current Controlled Trials, ISRCTN72328636. 119 health workers received the intervention. Case-management practices were assessed for 2269 children who needed treatment (1157 in the intervention group and 1112 in the control group). Intention-to-treat analysis showed that correct artemether-lumefantrine management improved by 23·7 percentage-points (95% CI 7·6–40·0; p=0·004) immediately after intervention and by 24·5 percentage-points (8·1–41·0; p=0·003) 6 months later. In resource-limited settings, malaria control programmes should consider use of text messaging to improve health workers' case-management practices. The Wellcome Trust.