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. 2019 Apr 23;2019(4):CD004317. doi: 10.1002/14651858.CD004317.pub5

Keder 1998.

Methods Single site, parallel group RCT
Location: Magee‐Womens Hospital clinic in Pittsburgh, PA, USA
Time frame: enrolment October 1993 to November 1994
Sample size calculation (and outcome of focus): based on published meta‐analysis of interventions to improve adherence for medical appointments, estimated OR 2.2 for improved follow‐up; assume 50% no‐show, type I error 0.05, and power 90%, 120 needed for each group
Participants General with N: 250 women attending clinic and willing to use DMPA for contraception.
Inclusion criteria:
  • access to telephone;

  • plan to return to same facility for continuing care.


Exclusion criteria:
  • currently receiving depot medroxyprogesterone treatment;

  • planning to undergo tubal ligation;

  • immediately postpartum;

  • unwilling to provide back‐up contact information.

Interventions Intervention:
  • Mail and telephone reminders of next injection 2 weeks before each scheduled injection.


Comparison:
  • Written appointment card.

Outcomes Discontinuation rate at 12 months, rate of on‐time injections (an injection received within 14 weeks of the prior injection was classified as 'on‐time' injection), reason for discontinuation, DMPA‐induced side effects
Follow‐up: 12 months
Notes Trial registration: no details provided
Funding: no details
Declarations of interest: no details provided
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Computer‐generated randomization list
Allocation concealment (selection bias) Unclear risk No information
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Women enrolled were told of their assignment; researchers not blinded
Blinding of outcome assessment (detection bias) 
 All outcomes High risk Investigator communicated that she did the analysis and was aware of group assignment
Incomplete outcome data (attrition bias) 
 All outcomes High risk Loss to follow‐up: according to data provided by researcher, 36% overall; reminder group, 39%; no reminder group, 33%
Report noted 17.6% loss for year‐end interview.
Selective reporting (reporting bias) Unclear risk No protocol was available, however, outcomes prespecified in the manuscript were reported on.
Other bias Low risk Appeared free of other sources of bias