A Mobile Phone Informational Reminder to Improve Eye Care Adherence Among Diabetic Patients in Rural China: A Randomized Controlled Trial
Open accessAbstract
Purpose To determine whether short message service (SMS) reminders improve adherence to scheduled ocular examinations among patients with diabetes in rural China. Design Randomized controlled trial. Methods This study enrolled consecutive patients with diabetes scheduled for eye examinations at 5 hospitals in low-income areas of Guangdong, China from March 1, 2015 to May 31, 2016. Participants were randomized (1:1) to receive automated SMS reminders containing information about diabetic retinopathy (DR) 1 week and 3 days prior to scheduled eye appointments (Intervention) or to appointments without reminders (Control). Regression models following intention-to-treat principles were used to estimate the association between the main outcome (attendance within ± 1 week of scheduled visit) and membership in the Intervention group, with and without adjustment for other potential predictors of follow-up. Secondary outcomes included change in DR knowledge score (1, worst; 5, best) and endline satisfaction with care (3, worst; 15, best). Results Among 233 patients, 119 (51.1%) were randomized to Intervention (age 59.7 ± 11.3 years, 52.1% men) and 114 (48.9%) to Control (58.7 ± 9.50 years, 49.1% men). All participants provided data for the main study outcome. Attendance at scheduled appointments for the Intervention group (51/119, [42.9%]) was significantly higher than for Controls (16/114, [14.0%], between-group difference 28.8% [95% confidence interval (CI) 17.9%, 39.8%], P < .001). Factors associated with attendance in multiple regression models included Intervention group membership (Relative Risk [RR] 3.04, 95% CI, 1.73-5.33, P < .001) and baseline DR knowledge (RR 1.47, 95% CI 1.21-1.78, P < .001). Improvement in Satisfaction (mean difference 1.08, 95% CI 0.70-1.46, P < .001) and DR knowledge (mean difference 1.30, 95% CI 0.96-1.63, P < .001) were significantly higher for the Intervention group. Total cost of the intervention was US$5.40/person. Conclusion Low-cost SMS informational reminders significantly improved adherence to, knowledge about, and satisfaction with care. Additional interventions are needed to further improve adherence.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence suggests the use of text reminders positively influences rates of referral uptake and this may enhance the impact of AI screening, thereby exaggerating effectiveness.
“Evidence suggests the use of text reminders positively influence rates of referral uptake and this may enhance the impact of AI screening, thereby exaggerating effectiveness24.”
From Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis (2026) · cites this paper as [24]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
E-health in low- and middle-income countries: findings from the Center for Health Market Innovations
Lewis, T., Synowiec, C., Lagomarsino, G., & Schweitzer, J. (2012) · Bulletin of the World Health Organization · doi:10.2471/blt.11.099820 · Cited by 319 · see citing works
Use of Mobile Phone Text Message Reminders in Health Care Services: A Narrative Literature Review
Kannisto, K. A., Koivunen, M. H., & Välimäki, M. A. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3442 · Cited by 302 · see citing works
Chen, Z.-W., Fang, L.-Z., Chen, L.-Y., & Dai, H.-L. (2008) · Journal of Zhejiang University SCIENCE B · doi:10.1631/jzus.b071464 · Cited by 231 · see citing works
Text messaging reminders to reduce non-attendance in chronic disease follow-up: a clinical trial
Liew, S.-M., Tong, S. F., Mun Lee, V. K., Ng, C. J., Leong, K. C., & Teng, C. L. (2009) · British Journal of General Practice · doi:10.3399/bjgp09x472250 · Cited by 134 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Rinaldi, G., Hijazi, A., & Haghparast-Bidgoli, H. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108084 · Cited by 85 · see citing works
Hangaard, S., Laursen, S. H., Andersen, J. D., Kronborg, T., Vestergaard, P., Hejlesen, O., & Udsen, F. W. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211064633 · Cited by 55 · see citing works
Leigh, J. A., Sherrington, A., Barber, A. R. J., Turner, A. W., Kidd, M., Powell, J., & Pope, C. (2026) · npj Digital Medicine · doi:10.1038/s41746-026-02616-3 · Cited by 2 · see citing works
- Authors
- Chen, T., Zhu, W., Tang, B., Jin, L., Fu, H., Chen, Y., Wang, C., Zhang, G., Wang, J., Ye, T., Xiao, D., Vignarajan, J., Xiao, B., Kanagasingam, Y., & Congdon, N.
- Affiliations
- Sun Yat-sen University (CN)
- Queen's University Belfast (GB)
- Shaoguan Railway Hospital (CN)
- Commonwealth Scientific and Industrial Research Organisation (AU)
- Corresponding author
- Congdon, Nathan
- ORCID
- Venue
- American Journal of Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 194
- Pages
- 54-62
- ISSN
- 0002-9394 (ISSN-L)
- OpenAlex
- W2883876846
- Cited by
- 42
- References
- 4
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 3 · 2020: 7 · 2019: 1
- FWCI
- 4.20
- Type
- journal article
- Language
- en
- Open access
- green
- pure.qub.ac.uk
- Licence
- Locations
- American Journal of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, cc-by-nc-nd)
- Funders
- Orbis International
- Fred Hollows Foundation (FHF)
- World Diabetes Foundation (WDF) (WDF12-705)
- Ulverscroft Foundation
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- diabetic retinopathy, SMS reminders, mobile health, appointment attendance, diabetes mellitus, rural China, diabetic eye care, patient satisfaction, health education, low-income populations, patient-provider communication, patient satisfaction with care delivery, patient satisfaction with care quality, patient satisfaction with care access
- MeSH terms
- Aged, Appointments and Schedules, China, Diabetic Retinopathy, Female, Humans, Male, Middle Aged, Patient Compliance, Rural Population, Reminder Systems, Cell Phone, Asian People, Text Messaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
