Effect of mobile phone reminder messages on adherence of stent removal or exchange in patients with benign pancreaticobiliary diseases: a prospectively randomized, controlled study

BMC Gastroenterology

Research Article

Shuixiang He¹  Yong Gu²  Lina Zhao³  Xuegang Guo⁴  Linhui Zhang⁴  Hui Luo⁴  Qin Tao⁴  Xiangping Wang⁴  Rui Huang⁴  Yanglin Pan⁴  Limei Wang⁴  Rongchun Zhang⁴  Zhiguo Liu⁴ 

[1] Department of Gastroenterology, the first affiliated hospital of Xi’an Jiao Tong university, Xi’an, China;Department of Gastroenterology, the first affiliated hospital of Xi’an Jiao Tong university, Xi’an, China;Digestive System Department, Shaanxi Provincial Crops Hospital of Chinese People’s Armed Police Force, Xi’an, China;Department of Radiotherapy, Xijing Hospital, Xian, China;Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, Shannxi, China;

关键词: Short message service;    Adherence;    Stent exchange;    ERCP;    Biliary stricture;   

DOI  :  10.1186/s12876-016-0522-4

 received in 2016-05-18, accepted in 2016-08-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPlastic and covered metal stents need to be removed or exchanged within appropriate time in case of undesirable complications. However, it is not uncommon that patients do not follow the recommendation for further stent management after Endoscopic Retrograde Cholangiopancreatography (ERCP). The effect of short message service (SMS) intervention monthly on the stent removal/exchange adherence in patients after ERCP is unknown at this time.MethodsA prospective, randomized controlled study was conducted. After receiving regular instructions, patients were randomly assigned to receive SMS reminding monthly (SMS group) for stent removal/exchange or not (control group). The primary outcome was stent removal/exchange adherence within appropriate time (4 months for plastic stent or 7 months for covered stent). Multivariate analysis was performed to assess factors associated with stent removal/exchange adherence within appropriate time. Intention-to-treat analysis was used.ResultsA total of 48 patients were randomized, 23 to the SMS group and 25 to the control. Adherence to stent removal/exchange was reported in 78.2 % (18/23) of patients receiving the SMS intervention compared with 40 % (10/25) in the control group (RR 1.98, 95 % CI 1.16–3.31; p = 0 · 010). Among patients with plastic stent insertion, the median interval time from stent implantation to stent removal/exchange were 90 days in the SMS group and 136 days in the control respectively (HR 0.36, 95 % CI 0.16–0.84, p = 0.018). No difference was found between the two groups regarding late-stage stent-related complications. The rate of recurrent abdominal pain tended to be lower in SMS group without significant difference (8.7 vs 28 %, p = 0.144). Multivariate logistic regression analyses revealed that SMS reminding was the only factor associated with adherence of stent removal/exchange (OR 6.73, 95 % CI 1.64–27.54, p = 0.008).ConclusionThis first effectiveness trial demonstrated that SMS reminding monthly could significantly increase the patient adherence to stent removal/exchange after ERCP.Trial registrationThe study was respectively registered on July 10 in 2016 at ClinicalTrials.gov (NCT02831127).

【 授权许可】

CC BY   
© The Author(s). 2016