The SMS-text Adherence support (StAR) study - Hardware and software infrastructure

This paper details the hardware and software infrastructure used to collect data and deliver a novel intervention in an on-going individually randomised three-arm parallel group trial in a resource-limited setting. The SMS-text Adherence support trial (StAR) tests the efficacy of a behavioural intervention delivered by SMS-text to support hypertension treatment adherence compared to usual care. The intervention is a structured program of clinic appointment and medication pick-up reminders, medication adherence support and hypertension-related education delivered remotely using an automated system of semi-tailored informational or interactive SMS-text messages delivered to the 1372 recruited participants. The technical infrastructure includes mobile device-based electronic data collection at the point of care with secure remote upload of the data; the intervention delivery system; real-time query identification for screening, enrolment and participant management procedures; and monitoring and evaluation of trial processes. We are using several open-source software platforms in conjunction with off-the-shelf hardware to set-up and run a randomised clinical trial of a novel intervention in a low-resource setting.