StAR-2D: SMS supporting treatment for people with type 2 diabetes
The project will test the effectiveness of sending short message service (SMS) texts in improving health outcomes and supporting medication adherence in patients with type 2 diabetes in the context of implementing a low-cost, mobile-health communication infrastructure in an operational setting.
Diabetes is a major burden to individuals and health care systems in low-resource settings. The prevalence of the disease is rising, and there is an increasing threat for future impact through visual impairment, kidney failure, neuropathy and increased rates of cardiovascular disease. Failure to translate the benefits of effective treatments into benefits for individual patients can often result from failure to take medicines as prescribed, a problem termed non-adherence. There is an association between better adherence to treatment, and better control and fewer complications for people with type 2 diabetes.
Reasons for not collecting or taking medications as intended are well documented and include psychological factors, lack of social support, low levels of health literacy and interactions with the health care system that do not support self-management. Better understanding of treatments and helping people deal with day-to-day can improve the collection and taking of medicines. Interventions delivered by short message system (SMS) text-message have been effective in increasing adherence to anti-retroviral therapy and other conditions. More research is needed to develop and test better ways to help people use new technology to improve their use of medicines.
We have developed a low-cost system as part of a trial of sending health messages using SMS to primary-care based hypertensive patients in the Western Cape (the StAR trial). This has shown better adherence and improved blood pressure control for people receiving the SMS messages compared to those not receiving the messages. We now wish to explore its use for people with diabetes, by offering a new approach to improving access to care through providing advice and support to patients with diabetes alongside usual care.
|Study Design:||Individually randomised controlled two-arm trial|
|Sponsor:||University of Oxford|
|Ethical Approval:||OXTREC No. 22-15|
|Chief Investigator:||Professor Andrew Farmer, University of Oxford|
Global Alliance for Chronic Disease in partnership with the UK Medical Research Council