Abstract
BackgroundPatient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT) on short message service (SMS) reminders, which significantly improved follow-up adherence in pediatric cataract treatment.MethodsRCTs published in English that reported the impact of SMS or telephone reminders on increasing or decreasing the follow-up rate (FUR) were selected from Medline, EMBASE, PubMed, and the Cochrane Library through February 2014. The impacts of SMS and telephone reminders on the FUR of patients were systematically evaluated by meta-analysis and bias was assessed.ResultsWe identified 13 RCTs reporting on 3276 patients with and 3402 patients without SMS reminders and 8 RCTs reporting on 2666 patients with and 3439 patients without telephone reminders. For the SMS reminders, the majority of the studies (>50%) were at low risk of bias, considering adequate sequence generation, allocation concealment, blinding, evaluation of incomplete outcome data, and lack of selective reporting. For the studies on the telephone reminders, only the evaluation of incomplete outcome data accounted for more than 50% of studies being at low risk of bias. The pooled odds ratio (OR) for the improvement of follow-up adherence in the SMS group compared with the control group was 1.76 (95% CI [1.37, 2.26]; P<0.01), and the pooled OR for the improvement of follow-up adherence in the telephone group compared with the control group was 2.09 (95% CI [1.85, 2.36]; P<0.01); both sets showed no evidence of publication bias.ConclusionsSMS and telephone reminders could both significantly improve the FUR. Telephone reminders were more effective but had a higher risk of bias than SMS reminders.
Highlights
Follow-up refers to the timely surveillance of health status and guidance in a medication regimen by various methods among patients who visited or were visited by medical staff. [1] Adherence to follow-up (AFU) is most commonly measured as the follow-up rate (FUR), which is called the attendance rate, [2] retesting rate, [3] or screen rate, [4] with different definitions and calculations according to the specific research background
As a medical process characterized by long-term observation, AFU plays an irreplaceable role in chronic disease management. [5,6,7,8] In addition to the treatment effect, AFU seriously affects clinical research implementation: participants who are enrolled but do not complete a trial can undermine the internal and external validities of the findings and cause bias when participants are not lost randomly but rather have certain characteristics
Of the 441 titles and abstracts screened, only 18 randomized controlled trial (RCT) were identified in our systematic review, including 10 studies only focused on short message service (SMS) reminders, 5 only focused on telephone reminders, and 3 focused on both SMS and telephone reminders (Figure 1)
Summary
Follow-up refers to the timely surveillance of health status and guidance in a medication regimen by various methods among patients who visited or were visited by medical staff. [1] Adherence to follow-up (AFU) is most commonly measured as the follow-up rate (FUR), which is called the attendance rate, [2] retesting rate, [3] or screen rate, [4] with different definitions and calculations according to the specific research background. [13] In our previous randomized controlled trial (RCT; ClinicalTrials.gov, NCT01417819), we demonstrated a successful and practical intervention with short message service (SMS) reminders to significantly improve the AFU of families with clinically meaningful pediatric eye care in a setting with limited resources. [2] In the present study, we aimed to systematically evaluate the published RCTs reporting on the impact of AFU in patients with SMS and/or telephone reminders, both of which are the most used features, varying in cost and convenience, in the era of mobile information technology. Patient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT) on short message service (SMS) reminders, which significantly improved follow-up adherence in pediatric cataract treatment
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