Browsing by Author "Free, Caroline"
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- ItemCochrane corner: text messaging to improve adherence to drugs for secondary prevention of cardiovascular disease.(0000-00-00) Adler, Alma J; Casas, Juan P; Martin, Nicole; Free, Caroline; Perel, Pablo
- ItemCorrection to: A randomized controlled trial of an intervention delivered by mobile phone app instant messaging to increase the acceptability of effective contraception among young people in Tajikista...(0000-00-00) McCarthy, Ona; Ahamed, Irrfan; Kulaeva, Firuza; Tokhirov, Ravshan; Saibov, Salokhiddin; Vandewiele, Marieka; Standaert, Sarah; Leurent, Baptiste; Edwards, Phil; Palmer, Melissa; Free, CarolineAfter publication of the original article 1 it came to the authors attention that there is a typo in the Results section
- ItemThe cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop.(2013-08-26) Guerriero, Carla; Cairns, John; Roberts, Ian; Rodgers, Anthony; Whittaker, Robyn; Free, CarolineBACKGROUND The txt2stop trial has shown that mobile phone based smoking cessation support doubles biochemically validated quitting at 6 months This study examines the cost effectiveness of smoking cessation support delivered by mobile phone text messaging METHODS The lifetime incremental costs and benefits of adding text based support to current practice are estimated from a UK NHS perspective using a Markov model The cost effectiveness was measured in terms of cost per quitter cost per life year gained and cost per QALY gained As in previous studies smokers are assumed to face a higher risk of experiencing the following five diseases lung cancer stroke myocardial infarction chronic obstructive pulmonary disease and coronary heart disease i e the main fatal or disabling but by no means the only adverse effects of prolonged smoking The treatment costs and health state values associated with these diseases were identified from the literature The analysis was based on the age and gender distribution observed in the txt2stop trial Effectiveness and cost parameters were varied in deterministic sensitivity analyses and a probabilistic sensitivity analysis was also performed FINDINGS The cost of text based support per 1 000 enrolled smokers is 16 120 which given an estimated 58 additional quitters at 6 months equates to 278 per quitter However when the future NHS costs saved as a result of reduced smoking are included text based support would be cost saving It is estimated that 18 LYs are gained per 1 000 smokers 0 3 LYs per quitter receiving text based support and 29 QALYs are gained 0 5 QALYs per quitter The deterministic sensitivity analysis indicated that changes in individual model parameters did not alter the conclusion that this is a cost effective intervention Similarly the probabilistic sensitivity analysis indicated a 90 chance that the intervention will be cost saving INTERPRETATION This study shows that under a wide variety of conditions personalised smoking cessation advice and support by mobile phone message is both beneficial for health and cost saving to a health system
- ItemDevelopment of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.(0000-00-00) McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; Lopez Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, CarolineBACKGROUND Unintended pregnancies can result in poorer health outcomes for women children and families Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan Bolivia and Palestine where unmet need for contraception is high among this group METHODS Guided by Intervention Mapping the following steps contributed to the development of the interventions 1 needs assessment 2 specifying behavioural change to result from the intervention 3 selecting behaviour change methods to include in the intervention 4 producing and refining the intervention content RESULTS The results of the needs assessment produced similar interventions across the countries The interventions consist of short daily messages delivered over 4 months delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan The messages provide information about contraception target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health The interventions each contain the same ten behaviour change methods adapted for delivery by mobile phone CONCLUSIONS The development resulted in a well specified theory based intervention tailored to each country It is feasible to develop an intervention delivered by mobile phone for young people in resource limited settings
- ItemThe effectiveness of M-health technologies for improving health and health services: a systematic review protocol.(2010-11-10) Free, Caroline; Phillips, Gemma; Felix, Lambert; Galli, Leandro; Patel, Vikram; Edwards, PhilipBACKGROUND The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes M health around the world FINDINGS To be included in the review interventions must aim to improve or promote health or health service use and quality employing any mobile computing and communication technology This includes 1 interventions designed to improve diagnosis investigation treatment monitoring and management of disease 2 interventions to deliver treatment or disease management programmes to patients health promotion interventions and interventions designed to improve treatment compliance and 3 interventions to improve health care processes e g appointment attendance result notification vaccination reminders A comprehensive electronic search strategy will be used to identify controlled studies published since 1990 and indexed in MEDLINE EMBASE PsycINFO Global Health Web of Science the Cochrane Library or the UK NHS Health Technology Assessment database The search strategy will include terms and synonyms for the following mobile electronic devices MEDs and a range of compatible media mobile phone personal digital assistant PDA handheld computer e g tablet PC PDA phone e g BlackBerry Palm Pilot Smartphone enterprise digital assistant portable media player i e MP3 or MP4 player handheld video game console No terms for health or health service outcomes will be included to ensure that all applications of mobile technology in public health and health services are identified Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies Data on objective and self reported outcomes and study quality will be independently extracted by two review authors Where there are sufficient numbers of similar interventions we will calculate and report pooled risk ratios or standardised mean differences using meta analysis DISCUSSION This systematic review will provide recommendations on the use of mobile computing and communication technology in health care and public health and will guide future work on intervention development and primary research in this field
- ItemMobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults.(0000-00-00) Palmer, Melissa J; Barnard, Sharmani; Perel, Pablo; Free, CarolineBACKGROUND Cardiovascular disease CVD is a major cause of disability and mortality globally Premature fatal and non fatal CVD is considered to be largely preventable through the control of risk factors via lifestyle modifications and preventive medication Lipid lowering and antihypertensive drug therapies for primary prevention are cost effective in reducing CVD morbidity and mortality among high risk people and are recommended by international guidelines However adherence to medication prescribed for the prevention of CVD can be poor Approximately 9 of CVD cases in the EU are attributed to poor adherence to vascular medications Low cost scalable interventions to improve adherence to medications for the primary prevention of CVD have potential to reduce morbidity mortality and healthcare costs associated with CVD OBJECTIVES To establish the effectiveness of interventions delivered by mobile phone to improve adherence to medication prescribed for the primary prevention of CVD in adults SEARCH METHODS We searched CENTRAL MEDLINE Embase and two other databases on 21 June 2017 and two clinical trial registries on 14 July 2017 We searched reference lists of relevant papers We applied no language or date restrictions SELECTION CRITERIA We included randomised controlled trials investigating interventions delivered wholly or partly by mobile phones to improve adherence to cardiovascular medications prescribed for the primary prevention of CVD We only included trials with a minimum of one year follow up in order that the outcome measures related to longer term sustained medication adherence behaviours and outcomes Eligible comparators were usual care or control groups receiving no mobile phone delivered component of the intervention DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane We contacted study authors for disaggregated data when trials included a subset of eligible participants MAIN RESULTS We included four trials with 2429 randomised participants Participants were recruited from community based primary care or outpatient clinics in high income Canada Spain and upper to middle income countries South Africa China The interventions received varied widely one trial evaluated an intervention focused on blood pressure medication adherence delivered solely through short messaging service SMS and one intervention involved blood pressure monitoring combined with feedback delivered via smartphone Two trials involved interventions which targeted a combination of lifestyle modifications alongside CVD medication adherence one of which was delivered through text messages written information pamphlets and self completion cards for participants and the other through a multi component intervention comprising of text messages a computerised CVD risk evaluation and face to face counselling Due to heterogeneity in the nature and delivery of the interventions we did not conduct a meta analysis and therefore reported results narratively We judged the body of evidence for the effect of mobile phone based interventions on objective outcomes blood pressure and cholesterol of low quality due to all included trials being at high risk of bias and inconsistency in outcome effects Of two trials targeting medication adherence alongside other lifestyle modifications one reported a small beneficial intervention effect in reducing low density lipoprotein cholesterol mean difference MD 9 2 mg dL 95 confidence interval CI 17 70 to 0 70 304 participants and the other found no benefit MD 0 77 mg dL 95 CI 4 64 to 6 18 589 participants One trial 1372 participants of a text messaging based intervention targeting adherence showed a small reduction in systolic blood pressure SBP for the intervention arm which delivered information only text messages MD 2 2 mmHg 95 CI 4 4 to 0 04 but uncertain evidence of benefit for the second intervention arm that provided additional interactivity MD 1 6 mmHg 95 CI 3 7 to 0 5 One study examined the effect of blood pressure monitoring combined with smartphone messaging and reported moderate intervention benefits on SBP and diastolic blood pressure DBP SBP MD 7 10 mmHg 95 CI 11 61 to 2 59 DBP 3 90 mmHg 95 CI 6 45 to 1 35 105 participants There was mixed evidence from trials targeting medication adherence alongside lifestyle advice using multi component interventions One trial found large benefits for SBP and DBP SBP MD 12 45 mmHg 95 CI 15 02 to 9 88 DBP MD 12 23 mmHg 95 CI 14 03 to 10 43 589 participants whereas the other trial demonstrated no beneficial effects on SBP or DBP SBP MD 0 83 mmHg 95 CI 2 67 to 4 33 DBP MD 1 64 mmHg 95 CI 0 55 to 3 83 304 participants Two trials reported on adverse events and provided low quality evidence that the interventions did not cause harm One study provided low quality evidence that there was no intervention effect on reported satisfaction with treatment Two trials were conducted in high income countries and two in upper to middle income countries The interventions evaluated employed between three and 16 behaviour change techniques according to coding using Michie s taxonomic method Two trials evaluated interventions that involved potential users in their development AUTHORS CONCLUSIONS There is low quality evidence relating to the effects of mobile phone delivered interventions to increase adherence to medication prescribed for the primary prevention of CVD some trials reported small benefits while others found no effect There is low quality evidence that these interventions do not result in harm On the basis of this review there is currently uncertainty around the effectiveness of these interventions We identified six ongoing trials being conducted in a range of contexts including low income settings with potential to generate more precise estimates of the effect of primary prevention medication adherence interventions delivered by mobile phone
- ItemMObile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomised controlled trial.(2013-12-19) Smith, Chris; Vannak, Uk; Sokhey, Ly; Ngo, Thoai D; Gold, Judy; Khut, Khemrin; Edwards, Phil; Rathavy, Tung; Free, CarolineProviding women with contraceptive methods following abortion is important to reduce repeat abortion rates yet evidence for effective post abortion family planning interventions are limited This protocol outlines the evaluation of a mobile phone based intervention using voice messages to support post abortion family planning in Cambodia
- ItemThe Sexunzipped trial: optimizing the design of online randomized controlled trials.(2013-12-16) Bailey, Julia V; Pavlou, Menelaos; Copas, Andrew; McCarthy, Ona; Carswell, Ken; Rait, Greta; Hart, Graham; Nazareth, Irwin; Free, Caroline; French, Rebecca; Murray, ElizabethSexual health problems such as unwanted pregnancy and sexually transmitted infection are important public health concerns and there is huge potential for health promotion using digital interventions Evaluations of digital interventions are increasingly conducted online Trial administration and data collection online offers many advantages but concerns remain over fraudulent registration to obtain compensation the quality of self reported data and high attrition
- ItemSmoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial.(2011-07-04) Free, Caroline; Knight, Rosemary; Robertson, Steven; Whittaker, Robyn; Edwards, Phil; Zhou, Weiwei; Rodgers, Anthony; Cairns, John; Kenward, Michael G; Roberts, IanSmoking cessation programmes delivered via mobile phone text messaging show increases in self reported quitting in the short term We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence which was biochemically verified at 6 months
- Item'Someone batting in my corner': experiences of smoking-cessation support via text message.(2013-11-25) Douglas, Nicolas; Free, CarolineThe txt2stop trial demonstrated that smoking cessation support delivered by text message doubles biochemically verified abstinence at 6 months There was no significant heterogeneity in any of the pre specified subgroups
- ItemThree controlled trials of interventions to increase recruitment to a randomized controlled trial of mobile phone based smoking cessation support.(2010-05-20) Free, Caroline; Hoile, Elizabeth; Robertson, Steven; Knight, RosemaryBACKGROUND Recruitment is a major challenge for trials but there is little evidence regarding interventions to increase trial recruitment We report three controlled trials of interventions to increase recruitment to the Txt2stop trial PURPOSE To evaluate Trial 1 The impact on registrations of a text message regarding an online registration facility Trial 2 The impact on randomizations of sending pound5 with a covering letter to those eligible to join the trial Trial 3 The impact on randomizations of text messages containing quotes from existing participants METHODS Single blind controlled trials with allocation concealment INTERVENTIONS Trial 1 A text message regarding our new online registration facility Trial 2 A letter with pound5 enclosed Trial 3 A series of four text messages containing quotes from participants The control group in each trial received standard Txt2stop procedures RESULTS Trial 1 3 6 17 470 of the intervention group and 1 1 5 467 of the control group registered for the trial risk difference 2 5 95 CI 0 6 4 5 0 0 470 of the intervention group and 0 2 1 467 of the control group registered successfully online risk difference 0 2 95 CI 0 6 0 2 Trial 2 4 5 11 246 of the intervention group and 0 4 1 245 of the control group were randomized into the Txt2stop trial risk difference 4 0 95 CI 1 4 6 7 Trial 3 3 5 14 405 of the intervention group and 0 0 406 of the control group were randomized into the Txt2stop trial risk difference 3 5 95 CI 1 7 5 2 LIMITATIONS There were no baseline data available for trial 1 Allocation of participant IDs in trials 2 and 3 were systematic CONCLUSION Sending a text message about an online registration facility increased registrations to Txt2stop but did not increase online registrations Sending a pound5 reimbursement for participants time and sending text messages containing quotes from existing participants increased randomizations into the Txt2stop trial Clinical Trials 2010 7 265 273 http ctj sagepub com
- ItemTwo controlled trials to increase participant retention in a randomized controlled trial of mobile phone-based smoking cessation support in the United Kingdom.(2011-10-20) Severi, Ettore; Free, Caroline; Knight, Rosemary; Robertson, Steven; Edwards, Philip; Hoile, ElizabethBACKGROUND Loss to follow up of trial participants represents a threat to research validity To date interventions designed to increase participants awareness of benefits to society of completing follow up and the impact of a telephone call from a senior female clinician and researcher requesting follow up have not been evaluated robustly PURPOSE Trial 1 aimed to evaluate the effect on trial follow up of written information regarding the benefits of participation to society Trial 2 aimed to evaluate the effect on trial follow up of a telephone call from a senior female clinician and researcher METHODS Two single blind randomized controlled trials were nested within a larger trial Txt2stop In Trial 1 participants were allocated using minimization to receive a refrigerator magnet and a text message emphasizing the benefits to society of completing follow up or to a control group receiving a simple reminder regarding follow up In Trial 2 participants were randomly allocated to receive a telephone call from a senior female clinician and researcher or to a control group receiving standard Txt2stop follow up procedures RESULTS Trial 1 33 5 327 of 976 of the intervention group and 33 8 329 of 974 of the control group returned the questionnaire within 26 weeks of randomization risk ratio RR 0 99 95 confidence interval CI 0 88 1 12 In all 83 3 813 of 976 of the intervention group and 82 2 801 of 974 of the control group sent back the questionnaire within 30 weeks of randomization RR 1 01 95 CI 0 97 1 05 Trial 2 31 20 of 65 of the intervention group and 32 20 of 62 of the control group completed trial follow up RR 0 93 95 CI 0 44 1 98 CONCLUSIONS In presence of other methods to increase follow up neither experimental method refrigerator magnet and text message emphasizing participation s benefits to society nor a telephone call from study s principal investigator increased participant follow up in the Txt2stop trial