JMIR Publications

ABSTRACT

Background:

Hypertension and diabetes represent the first and third highest contributors to global disability. While mobile health (mHealth) messaging programs have rapidly increased in low and middle income countries (LMICs), adaptations for specific patient health needs is a new approach to manage chronic conditions.

Objective:

The primary aim of this study is to develop and test an mHealth communication intervention using electronic data capture (by tablet) and voice messaging to improve hypertension and diabetes self-management in Cambodia. The study is designed to enhance the communication network between providers and patients using electronic data capture (by tablet) and voice messages targeting individuals with specific health management needs.

Methods:

Study design is a cluster randomized clinical trial (RCT) randomizing each of 75 Community Peer Educators (PEs), trained and coordinated by MoPoTsyo Patient Information Center in Phnom Penh, into one of three groups of 25 (approximately 60 patients each) to receive either (1) tablet + messages, (2) tablet only, or (3) no intervention (control). Total sample within each group includes 25 clusters and approximately 1,500 patients located in 7 Operating Districts in rural regions or urban slums in Cambodia. The interventions (Groups 1 and 2) were compared to usual PE monitoring without the tablet or mHealth messaging interventions. Focus groups and informant interviews were conducted to develop messages according to specific themes: medications adherence, laboratory testing, physician visits, obesity, smoking, and general lifestyle issues. Using the data received at monthly PE monitoring meetings, patients will receive specific messages based on their individual health challenges. Following completion of the intervention, clinical and process outcomes will be compared to baseline metrics between groups.

Results:

PEs were randomized in July 2017 and the intervention was implemented September 2017 through June 2018. Results of the qualitative research were used to develop the telephone messages according to six themes: medications adherence, laboratory testing, physician visits (either annual or for alert determined at PE visit), obesity/weight gain, smoking, and general lifestyle issues (diet, exercise, salt intake, etc.). Analyses are underway.

Conclusions:

This project is unique in its combining electronic data transfer which can be accessed immediately with voice messages most relevant to individual patients’ needs. Clinical Trial: This protocol was not registered into a trial registration.