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Background <p>Self-measurements of blood pressure (BP) or blood glucose (BG) at home are effective in controlling hypertension or diabetes among patients on treatment. However adherence to these measurements is poor in low income settings including Kenya. We assessed the effectiveness of mobile phone text message (SMS) reminders for self-measurements on BP, and BG control.</p> Methods <p>This was an open-label randomized controlled trial among low income patients from healthcare facilities in three Kenyan counties (Nairobi, Kiambu, and Vihiga). To be eligible, patients had to be an adult (18 years and above) with a diagnosis of hypertension or type 2 diabetes, own a mobile phone, and accept self-measurements at home. Patients with hypertension were randomized into three arms each with 94 patients receiving daily, weekly, and no SMS respectively. Patients with diabetes were randomized into two arms (weekly versus no SMS) each with 64 patients. The proportion of patients with controlled blood pressure (&lt; 140/90 mmHg), and controlled random blood glucose (&lt; 11∙00 mmol/L) estimated through a survey conducted after 12 months of follow-up were our primary outcomes. Our secondary outcome was the effect of SMS reminders on self-measurements. A multivariate Poisson regression was performed to determine the factors associated with BP or BG control and weused intention to treat analysis.</p> Results <p>Between January and December 2020, 252/282 (86∙2%) patients with hypertension completed the study. The frequency of self-measurements increased among patients with hypertension who received weekly SMS and this was independently associated associated with BP control [RR = 1∙34, 95%CI (1∙01–1∙78)]. Daily SMS was not associated with BP control (RR = 0∙89; 95%CI (0∙63 − 1∙27)]. For diabetes, 104/128 (78∙9%) completed the study and there was no significant effect of weekly SMS on BG control [RR = 0∙92; 95%CI (0∙71–1∙19).</p> Conclusions <p>Weekly SMS reminders among patients on BP self-monitoring substantially improved BP control. SMS reminders are thus recommended as an adjunct intervention to improve adherence to self-measurements of BP at home.</p> Trial registration <p>This study was registered in the Pan African Clinical Registry (PACTR202003783697033) on 30 Mar 2020.</p>

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Effectiveness of mobile phone text messages sent as reminders for self-monitoring of blood pressures and blood glucose at home among low income patients in Kenya: an open label randomized controlled trial

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  • 发表日期：

    2026年6月15日

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  • Gershim Asiki,
  • Peter Otieno,
  • Calistus Wilunda,
  • Caroline Karugu,
  • Babette van der Kloet,
  • Julia Teerling,
  • Angela Siteyi,
  • Marleen Hendriks,
  • Catherine Kyobutungi,
  • Judith van Andel

摘要

Background

Self-measurements of blood pressure (BP) or blood glucose (BG) at home are effective in controlling hypertension or diabetes among patients on treatment. However adherence to these measurements is poor in low income settings including Kenya. We assessed the effectiveness of mobile phone text message (SMS) reminders for self-measurements on BP, and BG control.

Methods

This was an open-label randomized controlled trial among low income patients from healthcare facilities in three Kenyan counties (Nairobi, Kiambu, and Vihiga). To be eligible, patients had to be an adult (18 years and above) with a diagnosis of hypertension or type 2 diabetes, own a mobile phone, and accept self-measurements at home. Patients with hypertension were randomized into three arms each with 94 patients receiving daily, weekly, and no SMS respectively. Patients with diabetes were randomized into two arms (weekly versus no SMS) each with 64 patients. The proportion of patients with controlled blood pressure (< 140/90 mmHg), and controlled random blood glucose (< 11∙00 mmol/L) estimated through a survey conducted after 12 months of follow-up were our primary outcomes. Our secondary outcome was the effect of SMS reminders on self-measurements. A multivariate Poisson regression was performed to determine the factors associated with BP or BG control and weused intention to treat analysis.

Results

Between January and December 2020, 252/282 (86∙2%) patients with hypertension completed the study. The frequency of self-measurements increased among patients with hypertension who received weekly SMS and this was independently associated associated with BP control [RR = 1∙34, 95%CI (1∙01–1∙78)]. Daily SMS was not associated with BP control (RR = 0∙89; 95%CI (0∙63 − 1∙27)]. For diabetes, 104/128 (78∙9%) completed the study and there was no significant effect of weekly SMS on BG control [RR = 0∙92; 95%CI (0∙71–1∙19).

Conclusions

Weekly SMS reminders among patients on BP self-monitoring substantially improved BP control. SMS reminders are thus recommended as an adjunct intervention to improve adherence to self-measurements of BP at home.

Trial registration

This study was registered in the Pan African Clinical Registry (PACTR202003783697033) on 30 Mar 2020.