State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Ophthalmology. 2012 Dec;119(12):2463-70. doi: 10.1016/j.ophtha.2012.06.046. Epub 2012 Aug 24.
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.
Randomized, controlled trial. This trial is registered with ClinicalTrials.gov, NCT01417819.
We included 258 parent-child pairs involved in the Childhood Cataract Program of the Chinese Ministry of Health.
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.
Number of follow-up appointments attended, additional surgeries, laser treatments, changes in eyeglasses prescription, and occurrence of secondary ocular hypertension.
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).
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.
儿童白内障的成功管理离不开定期随访。我们旨在评估针对白内障患儿家长的手机短信服务（SMS）是否可以提高随访依从性和及时进行手术的比例。
随机对照试验。本试验已在 ClinicalTrials.gov 注册，编号为 NCT01417819。
我们纳入了 258 对参与中国卫生部儿童白内障计划的亲子。
参与者按 1:1 随机分配至手机短信干预组或标准随访预约组。所有参与者均按方案安排至少接受 4 次随访。干预组的家长在预约前会收到 SMS 自动提醒。对照组的家长不会收到 SMS 或任何替代预约提醒。研究人员对眼部检查结果进行了盲法评估；但研究参与者和负责随机分组及发送短信的管理员未进行盲法处理。
随访预约的出席次数、额外手术、激光治疗、眼镜处方的变化以及继发性眼高压的发生情况。
在亲子参与者中，135 人被随机分配至短信干预组，123 人被分配至标准预约组。短信组的出席率（首次就诊为 97.8%；第二次为 91.9%；第三次为 92.6%；第四次为 83%）显著高于对照组（首次就诊为 87.8%；第二次为 69.9%；第三次为 56.9%；第四次为 33.3%）。通过 SMS 提醒，总随访次数增加了 47.2%（出席率的相对风险 [RR]为 1.47；95%置信区间 [CI]为 1.16-1.78；P = 0.003）。为使 1 名儿童增加 1 次就诊，需要提醒的人数（NNR）为 3（95%CI，1.8-4.2）。短信组共进行了 247 次临床干预，对照组进行了 134 次（RR，1.68；95%CI，1.37-1.99；P = 0.007）。为了进行 1 次额外的临床干预，NNR 为 5（95%CI，3.5-6.5）。
短信提醒显著提高了小儿白内障治疗的随访依从性。利用现有的手机资源可能是改善中国儿童白内障管理的有效且经济的策略。
作者没有与本文讨论的材料有关的任何专有或商业利益。
