National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh.
Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh.
J Hum Hypertens. 2024 Nov;38(11):765-771. doi: 10.1038/s41371-024-00942-1. Epub 2024 Aug 24.
Visit non-attendance is a common barrier to hypertension control in low and middle-income countries (LMICs). We aimed to evaluate the effectiveness of mobile text messaging in improving visit attendance among patients with hypertension in primary healthcare facilities in Bangladesh. A randomized A/B testing study was conducted with two patient groups: (1) patients regularly attending visits (regular patients) and (2) patients overdue for their follow-up clinic visit (overdue patients). Regular patients were randomized into three groups: a cascade of three text reminders, a single text reminder, or no text reminder. Overdue patients were randomized into two groups: a single text reminder or no text reminder. 20,072 regular patients and 12,708 overdue patients were enrolled. Among regular patients, visit attendance was significantly higher in the cascade reminder group and the single reminder group compared to the no reminder group (78.2% and 76.6% vs. 74.8%, p < 0.001 and 0.027, respectively). Among overdue patients, the single reminder group had a 5.8% higher visit attendance compared to the no reminder group (26.5% vs. 20.7%, p < 0.001). The results remained consistent in multivariable analysis; adjusted prevalence ratio (PR) was 1.04 (95% CI 1.02-1.06) for the cascade reminder group and 1.02 (95% CI 1.00-1.05) for the single reminder group among regular patients. The adjusted PR for the single reminder group vs. the no reminder group among overdue patients was 1.23 (95% CI 1.15-1.33). Text message reminders are an effective strategy for improving retention of patients in hypertension treatment in LMICs, especially for patients overdue to care.
就诊不规律是中低收入国家（LMICs）高血压控制的常见障碍。我们旨在评估通过手机短信提醒改善孟加拉国基层医疗机构高血压患者就诊规律的效果。采用随机 A/B 测试研究，纳入两组患者：（1）定期就诊的患者（规律就诊患者）和（2）错过随访就诊时间的患者（逾期就诊患者）。规律就诊患者随机分为三组：短信提醒级联（发送三条短信提醒）、单次短信提醒和无短信提醒。逾期就诊患者随机分为两组：单次短信提醒和无短信提醒。共纳入 20072 名规律就诊患者和 12708 名逾期就诊患者。与无短信提醒组相比，短信提醒级联组和单次短信提醒组的就诊率显著提高（78.2%和 76.6%比 74.8%，p<0.001 和 0.027）。逾期就诊患者中，短信提醒组的就诊率比无短信提醒组高 5.8%（26.5%比 20.7%，p<0.001）。多变量分析结果一致；规律就诊患者中，短信提醒级联组的调整后患病率比（PR）为 1.04（95%CI 1.02-1.06），短信提醒组为 1.02（95%CI 1.00-1.05）。逾期就诊患者中，短信提醒组与无短信提醒组的调整后 PR 为 1.23（95%CI 1.15-1.33）。短信提醒是提高 LMICs 高血压患者治疗保留率的有效策略，尤其是对逾期就诊的患者。
