Saleh 2018.

Study characteristics
Methods	Using mobile health to enhance outcomes of noncommunicable diseases care in rural settings and refugee camps: randomized controlled trial Clustered RCT (16 clusters and NR providers), conducted in 1) 16 PHCCs in Lebanon: 10 located in rural areas and belonging to the Lebanese MOPH PHC National Network and 6 UNRWA centres chosen from Palestinian refugee camps in Lebanon. These centres were randomly assigned into intervention and control groups. Five MOPH and 3 UNRWA centres were allocated to each of the intervention and control groups for a total of 8 sites in each of the groups. Mobile mHealth intervention. 2) Trained community health worker, research assistant, family physician, physicians and nurses in Lebanon 2 arms: 1. Control (usual care) (control arm) and 2. Intervention (eSahha mHealth mobile intervention) (intervention arm)
Participants	Control arm N: 300 Intervention arm N: 512, NA, NA Diabetes type: 4 Mean age: NR ± 10.99 % Male: 43.74 Longest follow‐up: 13 months
Interventions	Control arm: (usual care) Intervention arm: (eSahha mHealth mobile intervention) 1) Clinician education 2) Patient education 3) Promotion of self‐management 4) Patient reminders
Outcomes	Retinopathy screening Foot screening Glycated haemoglobin Smoking status
Funding source	Not reported
Notes	—
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not reported.
Allocation concealment (selection bias)	Low risk	Clustered RCT.
Provider's baseline characteristics (selection bias)	Unclear risk	Not reported.
Patient's baseline characteristics (selection bias)	Low risk	No significant differences between gender, setting and disease category across the 2 groups were identified using the Chi² test; the difference in age groups between intervention and control at baseline is statistically significant (P = 0.003).
Patient's baseline outcomes (selection bias)	Low risk	Data look similar.
Incomplete outcome data (attrition bias)	High risk	Some numbers under some categories may not add up to the total because of missing values. Very large losses indicated in Table 3.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias)	Unclear risk	Objective measure for HbA1c, eye, foot exam, unclear whether subjective measure of smoking status.
Selective reporting (reporting bias)	Unclear risk	Retrospectively published protocol. Methods match outcomes. Very large losses, which could have been influenced by selective outcome reporting.
Risk of contamination (other bias)	Low risk	Remotely delivered intervention. Very unlikely that control participants received mHealth intervention.
Other bias	High risk	Intervention bias could have taken place because QI collectors at PHCCs were aware of data collection post intervention. "As a matter of fact, the increased percentage of recorded dates of visits to PHCCs for HbA1c testing in both the control and intervention groups may be the result of improved documentation rather than an actual enhanced access to PHC services. Our results cannot be solely attributed to our intervention; the presence of advanced NCD programs at both the MOPH and UNRWA PHCC networks may have biased the findings, especially in the cases where a control site showed a significant change. Given that in some cases the owners of the phone numbers to which the SMSs were sent were not the patients themselves but rather family members, the interventional SMS messages may have not been transmitted to their final recipients (ie, patients) who are the target population of our study".