The effect of text messaging on hospital visits and blood pressure control among literate adults attending the outpatient department in Bingham University Teaching Hospital Jos, Nigeria

Abstract

Background: Non-attendance to hospital appointment and non-adherence to blood pressure lowering medication are major factors in sub-optimal control of high blood pressure. The aim of the study was to assess the effect of text messaging on improving hospital visits and blood pressure control in adult hypertensives in Bingham University Teaching Hospital Jos.

Methods: Seventy-two consenting adult hypertensives receiving care at the Out Patient Departments of the hospital were recruited and randomly allocated into two groups, with 35 participants in the Intervention and 37 in the Control group. Socio-demographic characteristics and clinical parameters were obtained from participants in both groups using standardized questionnaires. Text messages were sent to the Intervention group weekly and the participants were followed up every four weeks for 12 weeks. The main outcome was to determine if there was an improvement in adherence to hospital visits and blood pressure control. The data was imputed and analyzed using SPSS (Statistical Package for Social Sciences) software version 20. Relationships were determined using chi-square, students t-test and statistical means.

Results: Following intervention, there was a significant difference in the level of adherence to hospital visits between the two groups. This difference was statistically significant for the first (p=0.001), second (p=0.008) and third visits (p=0.002). At baseline, the systolic and diastolic blood pressures of the participants in the two groups were similar. At four, eight and 12 weeks post intervention, there was a statistically significance difference in the change in mean systolic (p= <0.000) and mean diastolic blood pressure (p= <0.000) between the two Control groups. There was also a statistically significant difference in the mean diastolic blood pressure (p=<0.000) between the two groups over the follow up period. Adherence to hospital visits led to an improvement in medication adherence and in turn blood pressure control in both groups.

Conclusion: Text messaging greatly improved adherence to hospital visits in the Intervention group compared to the Control group. There was also a significant difference in the change in mean blood pressure across the hospital visits in both groups.