2023-09-28 14:46:10 +00:00
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abstract: 'Background: Effective use of proven treatments for high blood pressure,
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a preventable health risk, is challenging for many patients. Prompts via
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mobile phone SMS-text messaging may improve adherence to clinic visits
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and treatment, though more research is needed on impact and patient
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perceptions of such support interventions, especially in low-resource
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settings.
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Method: An individually-randomised controlled trial in a primary care
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clinic in Cape Town (2012-14), tested the effect of an adherence support
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intervention delivered via SMS-texts, on blood pressure control and
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adherence to medication, for hypertensive patients. (Trial registration:
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ClinicalTrials.gov NCT02019823). We report on a qualitative evaluation
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that explored the trial participants'' experiences and responses to the
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SMS-text messages, and identified barriers and facilitators to
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delivering adherence support via patients'' own mobile phones. Two focus
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groups and fifteen individual interviews were conducted. We used
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comparative and thematic analysis approaches to identify themes and
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triangulated our analysis amongst three researchers.
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Results: Most participants were comfortable with the technology of using
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SMS-text messages. Messages were experienced as acceptable, relevant and
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useful to a broad range of participants. The SMS-content, the respectful
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tone and the delivery (timing of reminders and frequency) and the
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relational aspect of trial participation (feeling cared for) were all
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highly valued. A subgroup who benefitted the most, were those who had
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been struggling with adherence due to high levels of personal stress.
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The intervention appeared to coincide with their readiness for change,
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and provided practical and emotional support for improving adherence
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behaviour. Change may have been facilitated through increased
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acknowledgement of their health status and attitudinal change towards
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greater self-responsibility. Complex interaction of psycho-social
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stressors and health service problems were reported as broader
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challenges to adherence behaviours.
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Conclusion: Adherence support for treatment of raised blood pressure,
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delivered via SMS-text message on the patient''s own phone, was found to
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be acceptable, relevant and helpful, even for those who already had
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their own reminder systems in place. Our findings begin to identify for
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whom and what core elements of the SMS-text message intervention appear
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to work best in a low-resource operational setting, issues that future
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research should explore in greater depth.'
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affiliation: 'Leon, N (Corresponding Author), South African Med Res Council, Hlth
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Syst Res Unit, POB 19070 Fransie Van Zyl Dr, ZA-7505 Cape Town, South Africa.
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Leon, Natalie; Muller, Jocelyn, South African Med Res Council, Hlth Syst Res Unit,
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ZA-7505 Cape Town, South Africa.
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Surender, Rebecca, Univ Oxford, Dept Social Policy \& Intervent, Oxford OX1 2ER,
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England.
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Bobrow, Kirsty, Univ Cape Town, Dept Med, Div Diabet \& Endocrinol, Chron Dis Initiat
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Africa,Observ, ZA-7925 Cape Town, South Africa.
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Bobrow, Kirsty, Groote Schuur Hosp, Observ, ZA-7925 Cape Town, South Africa.
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Bobrow, Kirsty, Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford OX2 6GG,
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England.'
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article-number: '80'
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author: Leon, Natalie and Surender, Rebecca and Bobrow, Kirsty and Muller, Jocelyn
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and Farmer, Andrew
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author-email: Natalie.leon@mrc.ac.za
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author_list:
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- family: Leon
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given: Natalie
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- family: Surender
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given: Rebecca
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- family: Bobrow
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given: Kirsty
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- family: Muller
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given: Jocelyn
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- family: Farmer
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given: Andrew
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da: '2023-09-28'
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doi: 10.1186/s12875-015-0289-7
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eissn: 1471-2296
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files: []
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journal: BMC FAMILY PRACTICE
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keywords: 'Mobile phone-based SMS-messages; mHealth; Blood pressure treatment;
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Hypertension; Adherence; South Africa; low-and middle-income countries;
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primary-care; qualitative methodology; patient perspective'
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keywords-plus: 'HEALTH SYSTEM; GLOBAL BURDEN; INTERVENTIONS; MHEALTH; HYPERTENSION;
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MEDICATION; DISEASE; ADULTS; CARE'
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language: English
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month: JUL 3
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number-of-cited-references: '26'
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papis_id: cc6304bc4e44d7fea2f1b626c0e86ed6
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ref: Leon2015improvingtreatment
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times-cited: '58'
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title: 'Improving treatment adherence for blood pressure lowering via mobile phone
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SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence
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SuppoRt (StAR) trial'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000357252400003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '29'
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volume: '16'
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web-of-science-categories: Primary Health Care; Medicine, General \& Internal
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year: '2015'
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