Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence.
Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence.
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DOI：
10.1371/journal.pone.0266717
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Linde, Ditte S.
中科院分区：
文献类型：
--
作者：
Odegard, Emilie S.;Langbraten, Lena S.;Lundh, Andreas;Linde, Ditte S.
非洲越来越多的人使用移动的电话，导致了移动的卫生干预措施的增加，包括越来越多的双向短信干预措施。然而，在非洲背景下，它们对医疗保健结果的影响是不确定的。这篇系统性综述的目的是对涉及双向短信干预的随机试验进行横向研究，并评估其对医疗结果的影响。我们检索了Medline、Embase、科克伦对照试验中心注册中心、全球健康图书馆（截至2021年8月12日）和试验注册中心（截至2020年4月24日）。纳入了在非洲进行的已发表和未发表的试验，这些试验比较了双向短信干预与标准护理和/或单向短信干预。对报告对医疗预约出勤率和/或药物依从性的二分效应估计的试验进行偏倚风险评估，并纳入荟萃分析。后续报告了其他结局的结果。我们纳入了31项试验（28，563名受试者），均在撒哈拉以南非洲地区进行，具有广泛的临床条件。总体而言，主要荟萃分析包括10项不同的试验，其中两项有关于药物依从性和预约出勤率的数据。另外两项试验纳入敏感性分析。在纳入的12项试验中，3项被判定为总体偏倚风险低，9项被判定为总体偏倚风险高。双向短信并未改善预约出勤率，RR：1.03; 95% CI：0.95-1.12，I2 = 53%（5项试验，4374例受试者），但与标准治疗相比，改善了药物依从性，RR：1.14，95% CI：1.07-1.21，I2 = 8%（6项试验，2783例受试者）。双向短信似乎提高了药物依从性，但与标准护理相比，对预约出勤率的影响不确定。PROSPERO CRD 42020175810。
The growing access to mobile phones in Africa has led to an increase in mobile health interventions, including an increasing number of two-way text message interventions. However, their effect on healthcare outcomes in an African context is uncertain. This systematic review aims to landscape randomized trials involving two-way text message interventions and estimate their effect on healthcare outcomes. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, The Global Health Library (up to 12 August 2021) and trial registries (up to 24 April 2020). Published and unpublished trials conducted in Africa comparing two-way text message interventions with standard care and/or one-way text message interventions were included. Trials that reported dichotomous effect estimates on healthcare appointment attendance and/or medicine adherence were assessed for risk of bias and included in meta-analyses. Results of other outcomes were reported descriptively. We included 31 trials (28,563 participants) all set in Sub-Saharan Africa with a wide range of clinical conditions. Overall, ten different trials were included in the primary meta-analyses, and two of these had data on both medicine adherence and appointment attendance. An additional two trials were included in sensitivity analyses. Of the 12 included trials, three were judged as overall low risk of bias and nine as overall high risk of bias trials. Two-way text messages did not improve appointment attendance, RR: 1.03; 95% CI: 0.95–1.12, I2 = 53% (5 trials, 4374 participants) but improved medicine adherence compared to standard care, RR: 1.14, 95% CI: 1.07–1.21, I2 = 8% (6 trials, 2783 participants). Two-way text messages seemingly improve medicine adherence but has an uncertain effect on appointment attendance compared to standard care. PROSPERO CRD42020175810.
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