Effect of Mobile Phone Call Reminders With Standard Therapy Versus Standard Therapy Alone on Compliance With Iron Supplementation in Antenatal Women With Iron Deficiency Anemia: A Randomized Controlled Trial

Abstract

In spite of the implementation of the National nutritional anemia prophylaxis program in India, the prevalence of anemia during pregnancy is 50 in 100 women. One main cause for the high frequency of anemia among antenatal women in India is a lack of iron consumption. Few studies are available in the literature where efforts have been made to improve compliance with iron therapy. In the same line of thinking, it was decided in the present study to use mobile phone calls as a reminder for iron tablets. MethodThe present study is a randomized controlled open-label trial. Antenatal women with gestational age between 13-28 weeks of pregnancy diagnosed with iron deficiency anemia (Hb -8 to 11 gm/dl) having mobile phones were included in the study. Recruited women were randomized into two groups of study groups receiving standard therapy with the addition of fortnightly mobile phone call reminders and a control group receiving standard therapy alone. ResultsCompliance with iron supplementation was observed higher in the study group as compared to the control group (range of 48% to 93%). There was a mean hemoglobin rise in both the groups at the time of delivery compared with the hemoglobin at the time of recruitment (Study group-9.74 to 10.69, Control group-9.48 to 10.06). There was a statistically higher (0.00001) increase in the mean hemoglobin concentration in the study group (0.96 gm/dl) as compared to the control group (0.59 gm/dl). The reasons for poor compliance were boredom with taking daily oral iron therapy (66.66%), constipation (3.7%), forgetfulness (14.81%), and heartburn (14.81%). There was no statistical difference in the reason for poor compliance with iron supplementation in both groups. ConclusionThe present study concludes that mobile phone call reminders along with standard therapy with iron supplementation improve compliance with iron supplementation and lead to a greater rise in hemoglobin in antenatal women with iron deficiency anemia.

The Use of Mobile-phone Applications to Improve the Compliance of Pregnant Women to Take Iron Tablets: A Systematic Review

“…This can serve as a prompt for women to remember to take their dietary supplements (29). Mobile phone call reminders along with standard therapy proved led to a larger rise in hemoglobin among pregnant women with iron de ciency anemia (20) it also proved that mobile phone assistance can improve the compliance of pregnant women to take iron supplementation. Moreover, text message reminders can also improve patient medical compliance.…”

Effect of Educational Handouts With Standard Therapy Versus Standard Therapy Alone on Compliance With Oral Iron Supplementation in Antenatal Women With Iron Deficiency Anemia: A Randomized Controlled Trial

“…However, Khorshid et al [ 13 ], Byamugisha et al [ 14 ], Ahamed et al [ 15 ], Kaundal et al [ 16 ], Sunuwar et al [ 12 ], Abujilban et al [ 17 ], Srivastava et al [ 18 ], Nahrisah et al [ 19 ], Bumrungpert et al [ 20 ], Sontakke et al [ 21 ], Mithra et al [ 22 ], Dutta et al [ 23 ], Kassa et al [ 24 ], and Boti et al [ 25 ] reported mean ages ranging from 22-30 years of age. Similar to a study done by Sontakke et al [ 21 ], pregnant women in the present study were equally divided according to their parity status as nulliparous and multiparous in intervention and non-interventional groups. There were fewer multiparous women than nulliparous in previous studies undertaken by Wiradnyani et al [ 26 ], Byamugisha et al [ 14 ], Nahrisah et al [ 19 ], and Kassa et al [ 24 ].…”

“…The other studies conducted by Khorshid et al [ 13 ], Kaundal et al [ 16 ], and Bumrungpert et al [ 20 ] used serum ferritin in their inclusion criteria. Few other studies conducted by Abujilban et al [ 17 ] and Sontakke et al [ 21 ] included women with mobile phones. Most of the studies excluded women's obstetrical complications like severe anemia, hematological disorder, bleeding in pregnancy, heart failure, and a few others.…”

“…Mithra et al [ 22 ], Khorshid et al [ 13 ], Dutta et al [ 23 ], Wiradnyani et al [ 26 ], Byamugisha et al [ 14 ], Boti et al [ 25 ], Ahamed et al [ 15 ], Abujilban et al [ 17 ], Kassa et al [ 24 ], Srivastava et al [ 18 ], Bumrungpert et al [ 20 ], and Sontakke et al [ 21 ] applied either compliance or adherence or pill count to assess the oral intake of iron tablets. Although these studies employed compliance, adherence, and pill count to gauge the results, there are no set criteria to distinguish between great and poor compliance with iron supplementation during pregnancy.…”

“…But the increase in compliance in the intervention group was not statistically significant. Khorshid et al [ 13 ], Wiradnyani et al [ 26 ], Abujilban et al [ 17 ], Nahrisah et al [ 19 ], and Sontakke et al [ 21 ] found a positive effect on compliance with the association of different interventions. However, Byamugisha et al [ 14 ] and Srivastava et al [ 18 ] showed no statistical significance, supporting the findings of the present study.…”