Reducing Provider Workload While Preserving Patient Safety: A Randomized Control Trial Using 2-Way Texting for Postoperative Follow-up in Zimbabwe's Voluntary Medical Male Circumcision Program
Reducing Provider Workload While Preserving Patient Safety: A Randomized Control Trial Using 2-Way Texting for Postoperative Follow-up in Zimbabwe's Voluntary Medical Male Circumcision Program
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DOI：
10.1097/qai.0000000000002198
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发表时间：
2020-01-01
影响因子：
3.6
通讯作者：
Tshimanga, Mufuta
中科院分区：
文献类型：
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作者：
Feldacker, Caryl;Murenje, Vernon;Tshimanga, Mufuta
背景：自愿医疗男性包皮环切术（MC）是安全的：大多数男性愈合无并发症。然而，指南要求多次随访。在津巴布韦，移动的电话拥有率很高，卫生保健工作者严重短缺，MC规模迅速扩大，我们测试了双向短信（2wT）干预，以减少提供者的工作量，同时保障患者的安全。环境：津巴布韦哈拉雷附近的两个高容量设施提供MC。方法：一项前瞻性、非盲、非劣效性、随机对照试验，722名成年MC客户与手机按1：1随机分配。2wT患者（n = 362）仅在需要或怀疑不良事件（AE）时才对每日文本进行回复，并进行亲自随访。对照组（n = 359）接受常规面对面访视。要求所有男性在术后第14天返回进行审查。ae的
Background: Voluntary medical male circumcisions (MCs) are safe: the majority of men heal without complication. However, guidelines require multiple follow-up visits. In Zimbabwe, where there is high mobile phone ownership, severe health care worker shortages, and rapid MC scale up intersect, we tested a 2-way texting (2wT) intervention to reduce provider workload while safeguarding patient safety. Setting: Two high-volume facilities providing MC near Harare, Zimbabwe. Methods: A prospective, unblinded, noninferiority, randomized control trial of 722 adult MC clients with cell phones randomized 1:1. 2wT clients (n = 362) responded to a daily text with in-person follow-up only if desired or an adverse event (AE) was suspected. The control group (n = 359) received routine in-person visits. All men were asked to return on postoperative day 14 for review. AEs at