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The Impact of Text Message Reminders on Adherence to Antimalarial Treatment in Northern Ghana: A Randomized Trial

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  • Julia R G Raifman
  • Heather E Lanthorn
  • Slawa Rokicki
  • Günther Fink

Abstract

Background: Low rates of adherence to artemisinin-based combination therapy (ACT) regimens increase the risk of treatment failure and may lead to drug resistance, threatening the sustainability of current anti-malarial efforts. We assessed the impact of text message reminders on adherence to ACT regimens. Methods: Health workers at hospitals, clinics, pharmacies, and other stationary ACT distributors in Tamale, Ghana provided flyers advertising free mobile health information to individuals receiving malaria treatment. The messaging system automatically randomized self-enrolled individuals to the control group or the treatment group with equal probability; those in the treatment group were further randomly assigned to receive a simple text message reminder or the simple reminder plus an additional statement about adherence in 12-hour intervals. The main outcome was self-reported adherence based on follow-up interviews occurring three days after treatment initiation. We estimated the impact of the messages on treatment completion using logistic regression. Results: 1140 individuals enrolled in both the study and the text reminder system. Among individuals in the control group, 61.5% took the full course of treatment. The simple text message reminders increased the odds of adherence (adjusted OR 1.45, 95% CI [1.03 to 2.04], p-value 0.028). Receiving an additional message did not result in a significant change in adherence (adjusted OR 0.77, 95% CI [0.50 to 1.20], p-value 0.252). Conclusion: The results of this study suggest that a simple text message reminder can increase adherence to antimalarial treatment and that additional information included in messages does not have a significant impact on completion of ACT treatment. Further research is needed to develop the most effective text message content and frequency. Trial Registration: ClinicalTrials.gov NCT01722734

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  • Julia R G Raifman & Heather E Lanthorn & Slawa Rokicki & Günther Fink, 2014. "The Impact of Text Message Reminders on Adherence to Antimalarial Treatment in Northern Ghana: A Randomized Trial," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-10, October.
    • Handle: RePEc:plo:pone00:0109032
    DOI: 10.1371/journal.pone.0109032
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    1. Eduard Marinov, 2017. "The 2017 Nobel Prize in Economics," Economic Thought journal, Bulgarian Academy of Sciences - Economic Research Institute, issue 6, pages 117-159.
    2. Miguel Godinho de Matos & Pedro Ferreira, 2020. "The Effect of Binge-Watching on the Subscription of Video on Demand: Results from Randomized Experiments," Information Systems Research, INFORMS, vol. 31(4), pages 1337-1360, December.
    3. Committee, Nobel Prize, 2017. "Richard H. Thaler: Integrating Economics with Psychology," Nobel Prize in Economics documents 2017-1, Nobel Prize Committee.
    4. Cohen, Jessica & Saran, Indrani, 2018. "The impact of packaging and messaging on adherence to malaria treatment: Evidence from a randomized controlled trial in Uganda," Journal of Development Economics, Elsevier, vol. 134(C), pages 68-95.
    5. Ditte S Linde & Malene Korsholm & Johnson Katanga & Vibeke Rasch & Andreas Lundh & Marianne S Andersen, 2019. "One-way SMS and healthcare outcomes in Africa: Systematic review of randomised trials with meta-analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    6. Essl, Andrea & Steffen, Angela & Staehle, Martin, 2021. "Choose to reuse! The effect of action-close reminders on pro-environmental behavior," Journal of Environmental Economics and Management, Elsevier, vol. 110(C).
    7. John Guyton & Dayanand S. Manoli & Brenda Schafer & Michael Sebastiani, 2016. "Reminders & Recidivism: Evidence from Tax Filing & EITC Participation among Low-Income Nonfilers," NBER Working Papers 21904, National Bureau of Economic Research, Inc.
    8. Lenel, Friederike & Priebe, Jan & Satriawan, Elan & Syamsulhakim, Ekki, 2022. "Can mHealth campaigns improve CCT outcomes? Experimental evidence from sms-nudges in Indonesia," Journal of Health Economics, Elsevier, vol. 86(C).
    9. Cátia Batista & Marcel Fafchamps & Pedro C Vicente, 2022. "Keep It Simple: A Field Experiment on Information Sharing among Strangers [Changing Saving and Investment Behavior: The Impact of Financial Literacy Training and Reminders on Micro-Businesses]," The World Bank Economic Review, World Bank, vol. 36(4), pages 857-888.
    10. Danijela Vuletic, 2015. "How Effective are Reminders and Frames in Incentivizing Blood Donations," CERGE-EI Working Papers wp554, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    11. Thomas Bossuroy & Clara Delavallade & Vincent Pons, 2019. "Biometric Tracking, Healthcare Provision, and Data Quality: Experimental Evidence from Tuberculosis Control," NBER Working Papers 26388, National Bureau of Economic Research, Inc.
    12. Dupas, Pascaline & Jain, Radhika, 2023. "Can beneficiary information improve hospital accountability? Experimental evidence from a public health insurance scheme in India," Journal of Public Economics, Elsevier, vol. 220(C).
    13. Ricardo Maertens & Alessandro Tarozzi & Kazi Matin Ahmed & Alexander van Geen, 2018. "Demand for Information on Environmental Health Risk, Mode of Delivery, and Behavioral Change: Evidence from Sonargaon, Bangladesh," Working Papers id:12934, eSocialSciences.
    14. Cátia Batista & Marcel Fafchamps & Pedro C. Vicente, 2018. "Keep It Simple: A Field Experiment on Information Sharing in Social Networks," NBER Working Papers 24908, National Bureau of Economic Research, Inc.
    15. Giacomo Calzolari & Mattia Nardotto, 2017. "Effective Reminders," Management Science, INFORMS, vol. 63(9), pages 2915-2932, September.
    16. Alessandro Tarozzi & Ricardo Maertens & Kazi Matin Ahmed & Alexander van Geen, 2021. "Demand for Information on Environmental Health Risk, Mode of Delivery, and Behavioral Change: Evidence from Sonargaon, Bangladesh," The World Bank Economic Review, World Bank, vol. 35(3), pages 764-792.
    17. Beverly M. Ochieng & Lesley Smith & Bev Orton & Mark Hayter & Margaret Kaseje & Charles O. Wafula & Penina Ocholla & Franklin Onukwugha & Dan C. O. Kaseje, 2022. "Perspectives of Adolescents, Parents, Service Providers, and Teachers on Mobile Phone Use for Sexual Reproductive Health Education," Social Sciences, MDPI, vol. 11(5), pages 1-26, April.
    18. Grépin, Karen A. & Habyarimana, James & Jack, William, 2019. "Cash on delivery: Results of a randomized experiment to promote maternal health care in Kenya," Journal of Health Economics, Elsevier, vol. 65(C), pages 15-30.

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