One-way SMS and healthcare outcomes in Africa: Systematic review of randomised trials with meta-analysis

Ditte S. Linde, Malene Korsholm, Johnson Katanga, Vibeke Rasch, Andreas Lundh, Marianne S. Andersen

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Abstract

Background The impact of one-way SMS on health outcomes in Africa is unclear. We aimed to conduct a systematic review of one-way SMS randomised trials in Africa and a meta-analysis of their effect on healthcare appointments attendance and medicine adherence. Methods PubMed, Embase, CENTRAL, The Global Health Library, ClinicalTrials.gov, ICTRP, and PACTR were searched for published and unpublished trials in Africa without language restriction (up to April 2018). Trials reporting effect estimates on healthcare appointment attendance and medicine adherence were assessed for risk of bias and included in meta-analyses using random-effects models. Other outcomes were reported descriptively. The protocol is registered in PROSPERO, ID:CRD42018081062. Results We included 38 one-way SMS trials conducted in Africa within a broad range of clinical conditions. Eighteen trials were included in the meta-analyses, and four were assessed as overall low risk of bias. One-way SMS improved appointment attendance, OR:203; 95% CI:140–295 (12 trials, 6448 participants), but not medicine adherence, RR:110; 95% CI:098–123 (nine trials, 4213 participants). Subgroup analyses showed that one-way SMS had the highest impact on childhood immunization attendance, OR:369; 95% CI:167–813 (three trials, 1943 participants). There was no clear evidence of one-way SMS improving facility delivery, knowledge level (reproductive/antenatal health, hypertension), diabetes- and hypertension management. Conclusion In an African setting, the clinical effect of one-way SMS is uncertain except for appointment attendance where the effect seems to vary depending on which clinical condition it is used in.

Original languageEnglish
Article numbere0217485
JournalPLOS ONE
Volume14
Issue number6
Number of pages18
ISSN1932-6203
DOIs
Publication statusPublished - Jun 2019

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systematic review
meta-analysis
health services
Medicine
Meta-Analysis
Health
Delivery of Health Care
medicine
hypertension
Immunization
Medical problems
Reproductive Health
PubMed
childhood
Libraries
diabetes
immunization
Language
methodology

Cite this

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title = "One-way SMS and healthcare outcomes in Africa:: Systematic review of randomised trials with meta-analysis",
abstract = "Background The impact of one-way SMS on health outcomes in Africa is unclear. We aimed to conduct a systematic review of one-way SMS randomised trials in Africa and a meta-analysis of their effect on healthcare appointments attendance and medicine adherence. Methods PubMed, Embase, CENTRAL, The Global Health Library, ClinicalTrials.gov, ICTRP, and PACTR were searched for published and unpublished trials in Africa without language restriction (up to April 2018). Trials reporting effect estimates on healthcare appointment attendance and medicine adherence were assessed for risk of bias and included in meta-analyses using random-effects models. Other outcomes were reported descriptively. The protocol is registered in PROSPERO, ID:CRD42018081062. Results We included 38 one-way SMS trials conducted in Africa within a broad range of clinical conditions. Eighteen trials were included in the meta-analyses, and four were assessed as overall low risk of bias. One-way SMS improved appointment attendance, OR:203; 95{\%} CI:140–295 (12 trials, 6448 participants), but not medicine adherence, RR:110; 95{\%} CI:098–123 (nine trials, 4213 participants). Subgroup analyses showed that one-way SMS had the highest impact on childhood immunization attendance, OR:369; 95{\%} CI:167–813 (three trials, 1943 participants). There was no clear evidence of one-way SMS improving facility delivery, knowledge level (reproductive/antenatal health, hypertension), diabetes- and hypertension management. Conclusion In an African setting, the clinical effect of one-way SMS is uncertain except for appointment attendance where the effect seems to vary depending on which clinical condition it is used in.",
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One-way SMS and healthcare outcomes in Africa: Systematic review of randomised trials with meta-analysis. / Linde, Ditte S.; Korsholm, Malene; Katanga, Johnson; Rasch, Vibeke; Lundh, Andreas; Andersen, Marianne S.

In: PLOS ONE, Vol. 14, No. 6, e0217485, 06.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - One-way SMS and healthcare outcomes in Africa:

T2 - Systematic review of randomised trials with meta-analysis

AU - Linde, Ditte S.

AU - Korsholm, Malene

AU - Katanga, Johnson

AU - Rasch, Vibeke

AU - Lundh, Andreas

AU - Andersen, Marianne S.

PY - 2019/6

Y1 - 2019/6

N2 - Background The impact of one-way SMS on health outcomes in Africa is unclear. We aimed to conduct a systematic review of one-way SMS randomised trials in Africa and a meta-analysis of their effect on healthcare appointments attendance and medicine adherence. Methods PubMed, Embase, CENTRAL, The Global Health Library, ClinicalTrials.gov, ICTRP, and PACTR were searched for published and unpublished trials in Africa without language restriction (up to April 2018). Trials reporting effect estimates on healthcare appointment attendance and medicine adherence were assessed for risk of bias and included in meta-analyses using random-effects models. Other outcomes were reported descriptively. The protocol is registered in PROSPERO, ID:CRD42018081062. Results We included 38 one-way SMS trials conducted in Africa within a broad range of clinical conditions. Eighteen trials were included in the meta-analyses, and four were assessed as overall low risk of bias. One-way SMS improved appointment attendance, OR:203; 95% CI:140–295 (12 trials, 6448 participants), but not medicine adherence, RR:110; 95% CI:098–123 (nine trials, 4213 participants). Subgroup analyses showed that one-way SMS had the highest impact on childhood immunization attendance, OR:369; 95% CI:167–813 (three trials, 1943 participants). There was no clear evidence of one-way SMS improving facility delivery, knowledge level (reproductive/antenatal health, hypertension), diabetes- and hypertension management. Conclusion In an African setting, the clinical effect of one-way SMS is uncertain except for appointment attendance where the effect seems to vary depending on which clinical condition it is used in.

AB - Background The impact of one-way SMS on health outcomes in Africa is unclear. We aimed to conduct a systematic review of one-way SMS randomised trials in Africa and a meta-analysis of their effect on healthcare appointments attendance and medicine adherence. Methods PubMed, Embase, CENTRAL, The Global Health Library, ClinicalTrials.gov, ICTRP, and PACTR were searched for published and unpublished trials in Africa without language restriction (up to April 2018). Trials reporting effect estimates on healthcare appointment attendance and medicine adherence were assessed for risk of bias and included in meta-analyses using random-effects models. Other outcomes were reported descriptively. The protocol is registered in PROSPERO, ID:CRD42018081062. Results We included 38 one-way SMS trials conducted in Africa within a broad range of clinical conditions. Eighteen trials were included in the meta-analyses, and four were assessed as overall low risk of bias. One-way SMS improved appointment attendance, OR:203; 95% CI:140–295 (12 trials, 6448 participants), but not medicine adherence, RR:110; 95% CI:098–123 (nine trials, 4213 participants). Subgroup analyses showed that one-way SMS had the highest impact on childhood immunization attendance, OR:369; 95% CI:167–813 (three trials, 1943 participants). There was no clear evidence of one-way SMS improving facility delivery, knowledge level (reproductive/antenatal health, hypertension), diabetes- and hypertension management. Conclusion In an African setting, the clinical effect of one-way SMS is uncertain except for appointment attendance where the effect seems to vary depending on which clinical condition it is used in.

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DO - 10.1371/journal.pone.0217485

M3 - Journal article

C2 - 31170176

VL - 14

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 6

M1 - e0217485

ER -