Txt2stop - mobile phones based smoking cessation support

A systematic review of mobile phone based trials for NCD

Dr Cari FreeClinical Senior lecturer

London School of Hygiene and Tropical Medicine

A randomised controlled trial of mobile phone based smoking cessation support

Free C, Whittaker R, Knight R, Roberts I, Cairns J, Rogers A

LSHTM

CTRU Auckland

QUIT (Bosworth R)

Pilot funded by Cancer Research UK

Main trial funded by the MRC

Smoking leading cause of preventable death

Txt2stop

5800 smokers willing to quit

Allocated to txt2stop or control

Doubled biochemically validated quitting at six months

10.7% txt2stop versus 4.9% control, relative risk 2.20 (95% CI 1.80 to 2.68), p<0.0001.

Implemented UK with over 48,000 users since 2012

Systematic review of trials of mobile technology based interventions for health or

health care Promising results• Physical activity (only short term), hypertension• Appropriate disease management for providers

(11/25 outcomes showed statistically significant benefits)

Clear small benefits• appointment reminders. Mixed results few trials .e.g. asthma No clinically important benefits• Weight loss• Daily medication reminders RR 1.00 (95% CI

0.77 to 1.30)

Effects of texting interventions on HBA1C for diabetes

Overall (I-squared = 8.5%, p = 0.358)

FRANKLIN 2006

HANAUER 2009

YOO 2009

ID

Study

FARIDI 2008

VÄHÄTALO MA 2004

-0.27 (-0.48, -0.06)

-0.20 (-1.07, 0.67)

-0.10 (-0.97, 0.77)

-0.50 (-0.84, -0.16)

WMD (95% CI)

-0.40 (-0.93, 0.13)

0.00 (-0.36, 0.36)

100.00

5.79

5.75

38.42

Weight

%

15.73

34.32

-0.27 (-0.48, -0.06)

-0.20 (-1.07, 0.67)

-0.10 (-0.97, 0.77)

-0.50 (-0.84, -0.16)

WMD (95% CI)

-0.40 (-0.93, 0.13)

0.00 (-0.36, 0.36)

100.00

5.79

5.75

38.42

Weight

%

15.73

34.32

MED decreases MED increases 0-2 -1 1 2

Summary

• Where there is good evidence of benefit strong implementation plans are needed e.g. smoking cessation

• Lack of evidence in many areas for NCD

• New and improved NCD interventions needed.

• Well designed and adequately powered trials to demonstrate the effectiveness of interventions are needed in many areas.