***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS AND OBJECTIVES To compare drug adherence to lipid-lowering therapy among out patients with coronary artery disease who received information via short message service , via short message service and Micro Letter , or via phone only .  BACKGROUND Messaging applications and short message service are commonly used internationally . However , little is known about how coronary artery disease out patients in China may benefit from receiving health education through these technologies . DESIGN R and om sampling method . METHODS Data were collected from March-December 2013 . Subjects from Chengdu City , China , were r and omised to three groups : short message service , short message service + Micro Letter , and phone ( control ) . Appointment reminders and health information were delivered to patients in accordance with design ations . After six months , adherence to statin prescriptions was compared among the groups by using the Morisky Medication Adherence Scale . Logistic regression analysis was applied to determine those independent variables that were related to adherence . RESULTS The short message service and short message service + Micro Letter groups had better cumulative adherence ( lower Morisky Medication Adherence Scale scores ) after six months than phone group , and the short message service + Micro Letter group had better cumulative adherence ( lower Morisky Medication Adherence Scale scores ) than the short message service group . Female sex , older age and marriage show positive associations with adherence . CONCLUSIONS Short message service and messaging applications , such as Micro Letter , are effective means of providing discharged patients with reminders and coronary artery disease-related health information . Implementation of a short message service + Micro Letter program can improve outpatient adherence to medication . RELEVANCE TO CLINICAL PRACTICE This research offers useful information to help medical staff design effective interventions to improve medication compliance among coronary artery disease patients AIM Short message service ( SMS ) is an applied technology of communication that enables the transfer of information and can be used as a part of medical efforts to motivate clients to improve their behavior regarding drug consumption . This study attempts to observe the differences in patients '  behavior as a result of either using SMS to motivate their drug consumption or by using only health providers and outreach workers to monitor them . METHODS This study used a post-test-only controlled-group design with a simple r and om sampling technique and was held in Malang , Indonesia . The sample in this study consisted of 45 patients with tuberculosis ( TB ) who received motivating SMS messages and 45 patients with only health providers and outreach workers to monitor them . RESULTS Fisher 's Exact test using a 95 % confidence interval showed that the result of this study had a P-value of 0.059 , which means that there was no difference in compliance with drug consumption between the patients who received SMS messages and the patients who were under the supervision of health providers and outreach workers . CONCLUSION It is highly recommended that the application of SMS be included in TB treatment and the evaluation of patients as an alternative method of controlling patients ' compliance with consuming anti-TB drugs at home Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems . Antenatal care has the potential to reduce maternal morbidity and improve newborns ’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining . We evaluated the association between a mobile phone intervention and antenatal care in a re source -limited setting . We aim ed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy . Methods This study was an open label pragmatic cluster-r and omised controlled trial with primary healthcare facilities in Zanzibar as the unit of r and omisation . 2550 pregnant women ( 1311 interventions and 1239 controls ) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery . 24 primary health care facilities in six districts were r and omized to either mobile phone intervention or st and ard care . The intervention consisted of a mobile phone text-message and voucher component . Primary outcome measure was four or more antenatal care visits during pregnancy . Secondary outcome measures were tetanus vaccination , preventive treatment for malaria , gestational age at last antenatal care visit , and antepartum referral . Results The mobile phone intervention was associated with an increase in antenatal care attendance . In the intervention group 44 % of the women received four or more antenatal care visits versus 31 % in the control group ( OR , 2.39 ; 95 % CI , 1.03 - 5.55 ) . There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant . Conclusions The  wired mothers ’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care visits during pregnancy and there was a trend towards improved quality of care with more women receiving preventive health services , more women attending antenatal care late in pregnancy and more women with antepartum complications identified and referred . Mobile phone applications may contribute towards improved maternal and newborn health and should be considered by policy makers in re source -limited setting s . Trial registration Clinical Trials.gov , NCT01821222 PURPOSE The current malaria treatment in Zambia is more than 97 % effective when the regimen is strictly adhered to . However , the mean adherence rate in sub-Saharan Africa is only 38 % to 48 % . Poor pharmacoadherence remains a significant barrier to malaria control and elimination . The purpose of this study was to determine if adherence rates to a six-dose artemesinin-based combination therapy ( ACT ) treatment differ between patients who received  short message service ( SMS )  reminders and those who did not . This is the first study of its kind using SMS directly to the patient for ACT adherence in sub-Saharan Africa . DESIGN An experimental , r and omized controlled trial was conducted through a sample of 96 adult malaria patients at Fisenge Clinic in Zambia in 2014 . METHODS The intervention group received SMS messages to remind them to take their medication according to the prescribed regimen . An electronic pillbox was used to measure pharmacoadherence for both groups , and patients were classified as probably adherent or probably nonadherent . FINDINGS Data were analyzed using chi-square for association between the SMS intervention and pharmacoadherence , and logistic regression was used for predictors of adherence . No significant association was found between SMS reminders and pharmacoadherence ( χ(2 ) = 0.19 , df = 1 , p = .67 ) . Binary logistic regression indicated that there were no variables associated with adherence ( p > .05 ) . CONCLUSIONS SMS reminder messages did not appear to improve pharmacoadherence in malaria medication . CLINICAL RELEVANCE The study indicates few implication s to nursing practice due to the lack of association between SMS and adherence , but adds to current knowledge Objective To evaluate the effectiveness of daily text messages as a means to improve  caregivers ’ adherence to infant micronutrient powder ( MNP ) in rural Shaanxi Province of China . Methodology 638 infants aged 6–11 months in 234 villages were involved in a cluster-r and omized controlled trial ( RCT ) . All caregivers were given free infant MNP packets  at baseline in April 2013 and the follow-up survey was in July 2013 . We r and omly assigned 318 infants in 117 villages to treatment group  ( receiving daily text message ) and 320 infants in the other 117 villages as control group . Results On average , daily text messages  increased the number of MNP packets fed ( marginal effect = 4.63 ; 95 % confidence interval ( CI ) = 0.16 , 9.10 ) . The text message is more likely to increase the consumption of MNP packets if the primary caregiver was the mother ( marginal effect = 12.19 ; 95 % CI = 0.69 , 23.68 ) . Receiving the text message appears to significantly increase the likelihood of full adherence when the primary caregiver can either check ( odds ratio = 2.93 ; 95 % CI = 1.34 , 6.40 ) or knows how to send ( odds ratio = 3.26 ; 95 % CI = 1.53 , 6.97 ) text messages . Conclusion Daily text messages  improved the consumption of infant MNP packets . However , the impact was not large enough to increase the probability of caregivers being fully adherent to the feeding instruction , which is to feed 5–7 packets per week as recommended . In addition , when the mother is the caregiver and when the caregiver can check or knows how to send text messages there is greater adherence by the primary caregivers . Trial registration http://www.is rct n.com/IS RCT AIMS AND OBJECTIVES To determine the effectiveness of an electronic messaging support service for management of cardiovascular risk factors in patients with diabetes . BACKGROUND Microletter and short message service are widely used , but their health education benefit for people with type 2 diabetes mellitus has not been investigated . DESIGN Convenience sample study with r and omised group assignment . METHODS Participants completed survey question naires , physical and laboratory evaluations between May 2015 and May 2016 and were then r and omly assigned to two groups for receipt of a microletter + short message or a phone call ( control ) . Appointment reminders and health information were sent to the intervention patients by microletter + short message . Every three months , intervention patients and control patients were followed up by telephone . After 12 months , changes in cardiovascular risk factors in each group were evaluated and compared . RESULTS There were no statistically significant changes or between-group differences in daily smoking and drinking . There were statistically significant between-group differences in glycated haemoglobin ( p = .034 ) , postpr and ial plasma glucose ( p = .001 ) , postpr and ial insulin ( p = .005 ) , total cholesterol ( p = .038 ) and low-density lipoprotein ( p < .001 ) . Levels of glycated haemoglobin ( p = .011 ) , fasting plasma glucose ( p = .007 ) , postpr and ial plasma glucose ( p < .001 ) , fasting insulin ( p = 0.004 ) , postpr and ial insulin ( p < .001 ) , total cholesterol ( p < .001 ) and low-density lipoprotein ( p < .001 ) were found to be decreased significantly in intervention patients . Systolic blood pressure decreased significantly in patients only followed by telephone ( p = .014 ) . The microletter + short message intervention was an effective means of reducing cardiovascular risk in patients with type 2 diabetes mellitus . CONCLUSION Regular smartphone communication had a favourable impact on cardiovascular risk factors in patients with type 2 diabetes mellitus . RELEVANCE TO CLINICAL PRACTICE Regular smartphone communication has a favourable impact on cardiovascular risk factors in patients with type 2 diabetes mellitus Background Large investments are currently made in community – based complementary food supplement ( Ying Yang Bao , YYB ) programs to improve nutrition of young children in rural areas in China . However , there is a lack of knowledge about the experience and challenges of implementing YYB programs in China . We aim ed to : 1 ) monitor distribution of YYB ; 2 ) assess  children ’s adherence to and acceptability of YYB ; and 3 ) evaluate community – based strategies to improve the program . Methods This mixed methods evaluation study combined data from surveys and focus groups that took place during a controlled interventional evaluation trial . The trial aim ed to evaluate the effectiveness of  community – based YYB distribution on improving children 's health status in rural areas in China . We conducted five cross – sectional surveys with caregivers of children aged 6–23 months ( baseline survey ( N = 1804 ) in August 2012 and four follow – up cross – sectional surveys  : 1 ) N = 494 in January 2013 ; 2 ) N = 2187 in August 2013 ; 3 ) N = 504 in January 2014 ; and 4 ) N = 2186 in August 2014 ) in one rural county in Qinghai Province . We used a two – stage cluster sampling technique to select mothers with eligible children for each survey . Information was collected from caregivers on household characteristics , YYB consumption and acceptability in the surveys . High adherence in each survey was defined as children who consumed at least four YYB sachets during the previous week . A logistic regression model was developed to obtain odds ratios ( OR ) with 95 % confidence intervals of factors associated with high adherence . Also , we conducted 10 focus groups with73 caregivers and health workers involved in the YYB distribution . Content analysis was used to explore qualitative findings , which were used to gain deeper insight into the quantitative results . Results Around 90 % of caregivers had ever received YYB and more than 80 % of children  ever took YYB . Caregivers mainly knew about YYB through their village doctors . High adherence to YYB increased from 49.4 % in the first follow – up survey ( January 2013 ) to 81.4 % in the last follow – up survey ( August 2014 ; P < 0.0001 ) . Repeated training sessions with village doctors could increase adherence . However , due to unplanned YYB stock – out , caregivers did not receive YYB for six months , which may have led to a decrease of high adherence from 64.1 % in the second follow – up survey ( August 2013 ) to 53.6 % in the third follow – up survey ( January 2014 ; P < 0.00 
    Output:
    
This systematic review shed light on the most prominent health outcomes that can be improved using mHealth technology interventions in developing countries .