A Randomized Controlled Trial on the Effectiveness of Short Message Service (SMS) Reminders in Improving Postpartum Follow-up among Gestational Diabetes Mellitus Patients

Annie Jane Sarmiento, Diane Carla Bernardo, Iris Thiele Isip-Tan

Abstract

Objective: This study assessed whether Short Message Service (SMS) reminders would improve follow-up rate among Gestational Diabetes Mellitus (GDM) patients by 12 weeks postpartum.

Methodology In this single-center single blind randomized controlled trial, we assigned 308 patients with GDM to either one of two arms, usual care alone vs. usual care with SMS reminders. In the usual care group 154 patients received a 10-minute short lecture on GDM, and a 75g oral glucose tolerance test (OGTT) request prior to discharge while 154 patients in the SMS group received twice a week SMS reminders at 4 weeks, 8 weeks, and 10 weeks after the birth of their baby in addition to usual care. Primary outcome was clinic visit within 6 to 12 weeks postpartum with a 75g OGTT result.

Results: In our population, the overall follow-up rate was 19.8% (61/308). Follow up rates were 20.1% (31/154) for the Usual Care and 19.5% (30/154) for the SMS groups. The addition of SMS reminders was not associated with an increase in follow-up rate at 12 weeks postpartum (Adjusted RR 0.98, 95% CI 0.63 to 1.52, p-value 0.932). The use of Insulin or Metformin for GDM control was associated with increase follow-up (adjusted RR 1.92, 95% CI 1.20 to 3.07, p-value 0.006.

Conclusion SMS reminders did not improve postpartum follow-up rate among GDM patients at 12 weeks postpartum. 

Keywords

gestational diabetes, Short Message Service, reminder system

Full Text:

Abstract

References

Litonjua A, Waspadji S, Pheng CS. AFES Study Group on Diabetes in Pregnancy: Preliminary data on prevalence. Philipp J Intern Med. 1996;34(2):67-8.

Jimeno CA, for the Technical Review Committee of the UNITE for DM Clinical Practice Guidelines on the Diagnosis and Management of Diabetes. A summary of the Philippines UNITE for diabetes clinical practice guidelines for the diagnosis and management of diabetes (Part I: Screening and diagnosis of DM). J ASEAN Fed Endocr Soc. 2011;26(1):26-30. https://doi.org/10.15605/jafes.026.01.05.

Malong CL, Sia-Anastacio A, Andag-Silva A, Cunanan E. Incidence of postpartum diabetes and glucose intolerance among Filipino patients with gestational diabetes mellitus seen at a tertiary hospital. J ASEAN Fed Endocr Soc. 2013;2(1):56-63. https://doi.org/10.15605/jafes.028.01.11.

Dawson SI. Glucose tolerance in pregnancy and the long-term risk of cardiovascular disease. Diabetes Res Clin Pract. 2009;85(1):14-9. PMID: 19446355. https://doi.org/10.1016/j.diabres.2009.04.007.

Nielsen KK, Kapur A, Damm P, de Courten M, Bygbjerg IC. From screening to postpartum follow-up – the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review. BMC Pregnancy and Childbirth. 2014;14:41. PMID: 24450389 PMCID: PMC3901889 DOI: 10.1186/1471-2393-14-41.

Tovar A, Chasan-Taber L, Eggleston E, Oken E. Postpartum screening for diabetes among women with a history of gestational diabetes mellitus. Prev Chronic Dis. 2011;8(6):A124. http://www. cdc.gov/pcd/issues/2011/nov/11_0031.htm. Accessed 28 August 2016.

Stasenko, M, Liddell J, Cheng YW, Sparks TN, Killion M, Caughey AB. Patient counseling increases post-partum follow-up in women with gestational diabetes mellitus. Am J Obstet Gynecol 2011;204(6):522.e1-6. https://doi.org/10.1016/j.ajog.2011.01.057.

Hunt KJ, Conway DL. Who returns for post-partum glucose screening following gestational diabetes mellitus? Am J Obstet Gynecol. 2008;198(4):404.e1-6. PMID: 18241820 PMCID: PMC2612122. https://doi.org/10.1016/j.ajog.2007.09.015.

Kim C, McEwan NL, Keer EA, et al. Preventive counseling among women with histories of gestational diabetes mellitus. Diabetes Care 2007;30(10):2489-95. PMID: 17623826. https://doi.org/10.2337/dc07-0435.

Clark HD, Graham ID, Karovitch A, Keely EJ. Do postal reminders increase postpartum screening of diabetes mellitus in women with gestational diabetes mellitus? A randomized controlled trial. Am J Obstet Gynecol. 2009;200(6):634.e1-7. PMID: 19268878. https://doi.org/10.1016/j.ajog.2009.01.003.

Jeppesen C, Kristensen JK, Ovesen P, Maindal HT. The forgotten risk? A systematic review of the effect of reminder systems for postpartum screening for type 2 diabetes in women with previous gestational diabetes. BMC Res Notes. 2015;8:373. PMID: 26306499. PMCID: PMC4548707. https://doi.org/10.1186/s13104-015-1334-2.

Nouhjah S, Shahbazian H, Amoori N, et al. Postpartum screening practices, progression to abnormal glucose tolerance and its related risk factors in Asian women with a known history of gestational diabetes: A systematic review and meta-analysis. Diab Met Syndr. Clin Res Rev. 2017; 11 Suppl 2:S703-12. PMID: 28571777. https://doi.org/10.1016/j.dsx.2017.05.002.

National Telehealth Center. Internet, social media and mobile use of Filipinos in 2015. Available at https://telehealth.ph/2015/03/26/internet-social-media-and-mobile-use-of-filipinos-in-2015/. Accessed March 2016.

Abroms LC, Whittaker R, Free C, Mendel Van Alstyne J, Schindler-Ruwisch JM. Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps. Eysenbach G, ed. JMIR mHealth and uHealth. 2015;3(4):e107. doi:10.2196/mhealth.4917.

Kannisto KA, Koivunen MH, Välimäki MA. Use of mobile phone text message reminders in health care services: A narrative literature review. J Med Internet Res. 2014;16(10):e222. PMID: 25326646. PMCID: PMC4211035. https://doi.org/10.2196/jmir.3442.

Tamban C, Isip-Tan I, Jimeno C. Use of short message services (SMS) for the management of type 2 diabetes mellitus: A randomized controlled trial. J AASEAN Fed Endocr Soc. 2013;28(2):143-9. https://doi.org/10.15605/jafes.028.02.08.

Van Ryswyk EM, Middleton PF, Hague WM, Crowther CA. Postpartum SMS reminders to women who have experienced gestational diabetes to test for Type 2 diabetes: The DIAMIND randomized trial. Diabet Med. 2015;32(10):1368-76. PMID: 25816702. https://doi.org/10.1111/dme.12769.

Bandyopadhyay M, Small R, Davey MA. Attendance for postpartum glucose tolerance testing following gestational diabetes among South Asian women in Australia: A qualitative study. J Womens Health, Issues Care. 2015;4(1):. https://doi.org/10.4172/2325-9795.1000178.

Suffoletto B. Text message behavioral interventions: From here to where? Curr Opin Psychol. 2016;9:16-21. PMID: 26665157. NIHMSID: NIHMS725153. PMCID: PMC4671292. https://doi.org/10.1016/j.copsyc.2015.09.012.

Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4. PMID: 20164043. PMCID: PMC2836773. https://doi.org/10.2196/jmir.1376.