A study of women reminded by short message service for elective gynaecological surgery: a randomized controlled trial
Date
2014-03-31
Authors
Potgieter, J. F. A.
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Abstract
Wireless communicating networks are becoming more and more utilized. By using Short Message Service (SMS) via mobile phones, patients can be contacted regarding blood results, follow-up appointments and reminders for chronic medication.In this study the use of SMS was put to the test in South Africa, a middle income country.
Objectives:
1. To evaluate whether there is better compliance in patients who received a SMS, reminding them of the date of elective surgery, as opposed to patients who did not receive a reminder SMS.
2. To describe demographic and clinical information of women who are booked forelective gynaecological surgery at Chris Hani Baragwanath Academic Hospital
Methods:
This study was undertaken at Chris Hani Baragwanath Academic Hospital, which offers a gynaecological elective surgery list on every working day.As with any busy hospital, it is not uncommon for women to wait lengthy periods of time for their surgery Participants were recruited and followed-up between 30th May 2011 and 14th of December 2011. Eligible criteria included all women scheduled to undergo surgery with a waiting list of at least one month. Women who did not have mobile phones and women who objected to receiving SMS
communications from the researcher on their mobile phones were excluded. Participants less than 18yrs, inability to read English SMS and refusal to participate in the trail were excluded. This was a double-blinded randomized controlled trial, which assessed the impact of a reminder SMS, in addition to the traditional methods of ensuring return for gynaecological surgery on patients remembering to avail themselves for surgery on their specific date. These numbers were randomized by block randomization into intervention group and control group. The Research Randomiser Form v4.0 program was used. Twenty nine patients were randomized to the intervention group who received a reminder SMS and 29 patients to the control group who did not receive the reminder SMS. Only patients with personal cell phones were included in the study. The participants as well as the researcher were blinded and only the supervisor knew who of the participants were randomised in either group.
Results:
A total of 58 patients were enrolled in this study. Participants included in the study were allocated numbers. The study showed that even though the shortest waiting period was < 2 months and the longest >5 months there was no significant difference in the number of patients that returned for surgery (53% versus 47%). Most of the patients in this study were African, unemployed and agesranged from 17 – 78 years. The primary reasons for their return in order of frequency were the presence of a mass (60%), pain (59%) and bleeding (36%). One of the major findings of this study was that older patients tended not to return for surgery. Surprisingly, patients who waited longer from the time of booking of surgery to the date of surgery, tended to return more frequently. The main reasons for not returning were that patients did not have money for transport and four patients were unreachable and hence lost to follow-up.
Conclusion:
This study failed to show that reminders by SMS for elective gynaecological surgery are effective. It also demonstrated that older women were more likely not to return for surgery. Perhaps their ability to read or respond to SMS is more limited than younger women. The other significant finding of this study contrary to expectation is that longer waiting periods seemed to encourage a better return rate.
Description
A dissertation submitted to the University of Witwatersrand in partial fulfillment of the requirements for the Master of Medicine Speciality Obstetrics and Gynaecology. Johannesburg, 2013