Texting patients with schizophrenia and their lay health supporters in a resource-poor community setting is more effective than a free-medicine program alone in improving medication adherence and reducing relapses and re-hospitalizations, according to a study published April 23 in the open-access journal PLOS Medicine by Wenjie Gong of Central South University in Hunan, China, Dong (Roman) Xu of Sun Yat-sen University Global Health Institute, Guangdong, China and colleagues.
Schizophrenia is a leading cause of disability and, in low- and-middle-income countries, the treatment gap remains high; even when treatment is available, adherence to antipsychotics is low. Mobile phone text messaging has been shown to be useful to strengthen community- and family-based care in resource-poor settings due to its availability, reliability, and ease of use. But there has been no clear evidence that texting improves treatment adherence, symptoms or functioning in people with schizophrenia. Gong and colleagues hypothesized that mobile phone texting could improve schizophrenia care in resource-poor community settings compared with a free-medicine, community-based program alone. To test this idea, the researchers developed an intervention called LEAN (Lay health supporters, Electronic platform with mobile texting for medication reminders, health education and monitoring, Award of token gifts for positive behavioral improvement, and iNtegration into health systems).
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