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Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial.
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. andrew.farmer@phc.ox.ac.uk.
BMC Public Health
|October 22, 2021
Summary
Short message service (SMS) text messaging did not improve glycemic control in type 2 diabetes patients. However, SMS interventions showed a positive impact on blood pressure and treatment goal achievement in low-resource settings.
Area of Science:
- Public Health
- Digital Health Interventions
- Diabetes Management
Background:
- Poor adherence to diabetes medication negatively impacts patient outcomes.
- Mobile phone-based interventions, specifically short message service (SMS) texts, offer a cost-effective approach to improve adherence.
Purpose of the Study:
- To evaluate the effectiveness of SMS text messaging in enhancing health outcomes for adults with type 2 diabetes in low-resource settings.
Main Methods:
- A 12-month randomized trial (StAR2D) involving 1186 adults with type 2 diabetes in South Africa and Malawi.
- Participants were assigned to either SMS text messaging (four weekly messages) or usual care.
- Primary outcome was change in HbA1c; secondary outcomes included medication adherence, blood pressure, lipids, cardiovascular risk, and treatment goal achievement.
Main Results:
- No significant difference in HbA1c reduction between groups.
- A significant reduction in systolic blood pressure was observed in the SMS intervention group (3.46 mmHg, P=0.001).
- The intervention group showed a higher proportion of participants achieving treatment goals (36.0% vs 26.8%, P=0.001).
Conclusions:
- SMS text messaging alone did not improve glycemic control in type 2 diabetes in these settings.
- The intervention showed potential benefits for blood pressure and achieving treatment goals, though mechanisms require further investigation.
- Integrating SMS interventions with health system strengthening and self-management support may be necessary for optimal results.
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