title: Mobile phone intervention for increasing adherence to treatment for type 2 diabetes in an urban area of Bangladesh: protocol for a randomized controlled trial.
abstract: BACKGROUND
  Mobile phone technologies including SMS (short message service) have been used to improve the delivery of health services in many countries. However, data on the effects of mobile health technology on patient outcomes in resource-limited settings are limited. The aim of this study therefore is to measure the impact of a mobile phone SMS service on treatment success of newly diagnosed type 2 diabetes in an urban area of Bangladesh.
  
  
  METHODS
  This is a single-centred randomized controlled intervention trial (prospective) comparing standard-of-care with standard-of-care plus a mobile phone-based SMS intervention for 6 months. A total of 216 participants with newly diagnosed type 2 diabetes will be recruited. Data will be collected at the outpatient department of Bangladesh Institute of Health Science (BIHS) hospital at baseline and after 6 months. The primary outcome measure will be change in HbA1c between baseline and 6 months. The secondary outcome measures are self-reported medication adherence, clinic attendance, self-reported adoption of healthy behaviours, diabetes knowledge, quality of life and cost effectiveness of the SMS intervention. The inclusion criteria will be as follows: diagnosed as patients with type 2 diabetes by the BIHS physician, using oral medication therapy, living in Dhaka city, registered with the BIHS hospital, using a mobile phone, willing to return for follow up after 6 months and providing written informed consent. Participants will be allocated to control and intervention arms after recruitment using a randomization software. Data will be collected on socio-demographic and economic information, mobile phone use and habits, knowledge of prevention, management and complications of diabetes, self-perceived quality of life assessment, self-reported diseases, medical history, family history of diseases, medication history, medication adherence, health seeking behaviour, tobacco use, physical activity, diet, mental health status, life events and disability, anthropometric measurements of weight, height, blood pressure and blood tests for HbA1c.
  
  
  CONCLUSIONS
  Mobile phone SMS services have the potential to communicate with diabetes patients and to build awareness about the disease, improve self-management and avoid complications also in resource-limited setting. If this intervention proves to be efficient and cost-effective in the current trial, large-scale implementation could be undertaken.
  
  
  BACKGROUND
  DRKS00005188 .
authors.affiliation: Center for Control of Chronic Diseases, International Center for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. shariful.islam@icddrb.org.|Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Leopoldstrasse 7, 80802, Munich, Germany. shariful.islam@icddrb.org.
authors.forename: Sheikh Mohammed Shariful
authors.initials: SM
authors.lastname: Islam
authors.affiliation: Diabetes Center, Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany. andreas.lechner@med.uni-muenchen.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lechner
authors.affiliation: Diabetes Center, Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany. uta.ferrari@med.uni-muenchen.de.
authors.forename: Uta
authors.initials: U
authors.lastname: Ferrari
authors.affiliation: Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Leopoldstrasse 7, 80802, Munich, Germany. Froeschl@lrz.uni-muenchen.de.
authors.forename: Guenter
authors.initials: G
authors.lastname: Froeschl
authors.affiliation: Center for Control of Chronic Diseases, International Center for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. dsalam@icddrb.org.
authors.forename: Dewan Shamsul
authors.initials: DS
authors.lastname: Alam
authors.affiliation: Economic Evaluations, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Munich, Germany. holle@helmholtz-muenchen.de.
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.affiliation: Diabetes Center, Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany. jochen.seissler@med.uni-muenchen.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Seissler
authors.affiliation: Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. Louis.Niessen@liverpool.ac.uk.
authors.forename: Louis W
authors.initials: LW
authors.lastname: Niessen
mesh_terms: D001459:Bangladesh; D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D012648:Self Care / Q000379:methods*; D060145:Text Messaging; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents