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Effectiveness of a short message reminder in increasing compliance with pediatric cataract treatment: a randomized
Haotian Lin1, Weirong Chen, Lixia Luo
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Insights
Mobile phone SMS reminders significantly improved follow-up adherence for childhood cataract treatment. This cost-effective strategy enhances pediatric eye care management by increasing appointment attendance and clinical interventions.
Area of Science:
- Ophthalmology
- Public Health
- Digital Health
Background:
- Regular follow-up is crucial for managing childhood cataracts.
- Adherence to follow-up appointments can be challenging in pediatric care.
- Mobile phone penetration is high, offering potential for health interventions.
Purpose of the Study:
- To evaluate the effectiveness of mobile phone short message service (SMS) reminders for parents of children with cataract.
- To determine if SMS reminders improve follow-up adherence and timely procedures.
- To assess the impact on clinical interventions in pediatric cataract management.
Main Methods:
- A randomized controlled trial involving 258 parent-child pairs.
- Intervention group received SMS reminders for appointments; control group received standard care.
- Follow-up adherence, additional surgeries, laser treatments, and prescription changes were monitored.
Main Results:
- SMS reminders significantly increased follow-up attendance rates across all scheduled visits (47.2% increase).
- The number needed to remind (NNR) for one additional visit was 3.
- Clinical interventions increased by 68% in the SMS group (NNR of 5).
Conclusions:
- SMS reminders are an effective and economical strategy to improve pediatric cataract management.
- Leveraging mobile technology can enhance patient adherence and treatment outcomes.
- This approach holds promise for improving childhood eye care in resource-limited settings.
Objective:
Regular follow-up is essential to successful management of childhood cataract. We sought to assess whether a mobile phone short message service (SMS) for parents of children with cataract could improve follow-up adherence and the proportion of procedures performed in timely fashion.
Design:
Randomized, controlled trial. This trial is registered with ClinicalTrials.gov, NCT01417819.
Participants:
We included 258 parent-child pairs involved in the Childhood Cataract Program of the Chinese Ministry of Health.
Methods:
Participants were randomized (1:1) to a mobile phone SMS intervention or standard follow-up appointments. All participants were scheduled to attend ≥ 4 follow-up appointments according to the protocol. Parents in the intervention group received SMS automated reminders before scheduled appointments. The control group parents did not receive SMSs or any alternative reminder of scheduled appointments. Regular ocular examinations and analyses were performed by investigators masked to group allocation; however, study participants and the manager in charge of randomization and sending SMSs were not masked.
Main Outcome Measures:
Number of follow-up appointments attended, additional surgeries, laser treatments, changes in eyeglasses prescription, and occurrence of secondary ocular hypertension.
Results:
Among parent-child participants, 135 were randomly assigned to the SMS intervention and 123 to standard appointments. Attendance rates for the SMS group (first visit, 97.8%; second, 91.9%; third, 92.6%; fourth, 83%) were significantly higher than those for the control group (first visit, 87.8%; second, 69.9%; third, 56.9%; fourth, 33.3%). The increase in attendance rate for total number of follow-up visits with SMS reminders was 47.2% (relative risk [RR] for attendance, 1.47; 95% confidence interval [CI], 1.16-1.78; P = 0.003). The number needed to remind (NNR) to gain 1 additional visit by 1 child was 3 (95% CI, 1.8-4.2). A total of 247 clinical interventions were carried out in the SMS group and 134 in the control group (RR, 1.68; 95% CI, 1.37-1.99; P = 0.007). The NNR to result in 1 additional clinical intervention was 5 (95% CI, 3.5-6.5).
Conclusions:
The SMS reminders significantly improved follow-up adherence in pediatric cataract treatment. Using readily available mobile phone resources may be an effective and economic strategy to improve management of childhood cataract in China.
Financial Disclosure(S):
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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