The effect of text reminders on the uptake of the NHS Diabetes Prevention Programme after gestational diabetes
| ISRCTN | ISRCTN14584775 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN14584775 |
| Integrated Research Application System (IRAS) | 346821 |
| Central Portfolio Management System (CPMS) | 64610 |
| Sponsor | University of Oxford |
| Funder | The British Diabetic Association |
- Submission date
- 03/11/2025
- Registration date
- 23/07/2026
- Last edited
- 23/07/2026
- Recruitment status
- Not yet recruiting
- Overall study status
- Ongoing
- Condition category
- Pregnancy and Childbirth
Plain English summary of protocol
Background and study aims
The NHS Diabetes Prevention Programme (NHS-DPP) is a nine-month course that supports people who are at high risk of developing type 2 diabetes. It helps them lower their risk and improve their long-term health. Women who have had gestational diabetes—a type of diabetes that starts during pregnancy—are much more likely to develop type 2 diabetes later in life. Although they are eligible for the NHS-DPP, many do not attend. This study tests whether sending reminder text messages to these women increases the number who join and complete the programme.
Who can participate?
Women with a previous diagnosis of gestational diabetes who are registered with a participating GP practice may be included in the study.
What does the study involve? (for participants)
Participants may receive a text message from their GP practice encouraging them to join the NHS-DPP. They do not need to do anything else for the study, and their usual care continues as normal.
What are the possible benefits and risks of participating?
Joining the NHS-DPP may help reduce the risk of developing type 2 diabetes and improve overall health. There are no known risks from receiving the text message, and taking part in the programme is voluntary.
Where is the study run from?
University of Oxford (UK)
When is the study starting and how long is it expected to run for?
July 2026 to September 2028
Who is funding the study?
British Diabetic Association
Who is the main contact?
Moscho Michalopoulou, moscho.michalopoulou@phc.ox.ac.uk
Contact information
Public, Scientific
Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Woodstock Road
Oxford
OX2 6GG
United Kingdom
 ORCID ID |
0000-0002-6063-3307 |
|---|---|
| Phone | +44 (0) 186528929 |
| moscho.michalopoulou@phc.ox.ac.uk |
Principal investigator
Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd
Oxford
OX26GG
United Kingdom
| nerys.astbury@phc.ox.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Interventional randomized controlled trial |
| Secondary study design | Randomised controlled trial |
| Scientific title | A cluster trial to increase uptake of the NHS-DPP in women with a history of gestational diabetes mellitus (GDM) |
| Study acronym | ACT-UP |
| Study objectives | Primary: In women with a history of gestational diabetes, determine if sending text reminders changes uptake of the NHS Diabetes Programme, compared with current standard practice Secondary: 1. In women with a history of gestational diabetes, to determine if receiving text reminders changes referral to the NHS Diabetes Prevention Programme, compared with current standard practice 2. In women with a history of gestational diabetes, to determine if receiving text reminders changes the number of NHS Diabetes Prevention Programme sessions attended compared with current standard practice 3. In women with a history of gestational diabetes, to determine if receiving text reminders changes the completion of the NHS Diabetes Prevention Programme compared to current standard practice 4. In women with a history of gestational diabetes, to explore heterogeneity in referral, uptake, attendance and completion of the NHS Diabetes Prevention Programme by characteristics such as patient age, ethnicity, socioeconomic status |
| Ethics approval(s) |
Approved 01/10/2025, Medical Sciences Interdivisional Research Ethics Committee (MS IDREC) (Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Woodstock Road, Oxford, OX2 6GG, United Kingdom; -; ethics@medsci.ox.ac.uk), ref: 2079895, 25/HRA/2166 |
| Health condition(s) or problem(s) studied | Gestational diabetes mellitus |
| Intervention | Practices randomised into the intervention arm will also nominate a member of the administration staff to attend a one-hour training session on running the search and sending the text messages. Once the search is completed, practices will send the target patients the first text message. This initial text message will establish that (1) the patients are at an increased risk of T2DM and heart disease due to their GDM diagnosis, and (2) that by self-referring themselves into the NHS-DPP they will be able to get help with implementing lifestyle changes that help to mitigate this risk. Importantly, the messages will include patients' NHS numbers for them to include this in their self-referral form. Two weeks after the first text message is sent, a second text message will be sent, reminding patients to self-refer and of their NHS numbers. Anonymised individual-level data will be obtained through the practices and/or NHS-DPP database. The outcomes regarding patient attendance and referral rates will be obtained on (a) the total number of women in the practice that have had a GDM diagnosis, (b) whether these patients have a recorded referral to the NHS-DPP (c) the number of sessions attended by target patients. The final dataset will be requested at the end of follow-up for all practices (15-month follow up per practice). In this study, baseline is defined as uptake of the programme three months prior to randomisation. As for follow-up, this is defined here as being fifteen months after running the search for control practices, or fifteen months after the date of the second text message for intervention practices. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
Uptake, defined as attendance of at least one session of the NHS Diabetes Prevention Programme, measured 3 months after sending the text messages for practices in the intervention arm and 3 months after the database search for practices in the control arm |
| Key secondary outcome measure(s) |
1. The number of women with a history of gestational diabetes referred to the NHS Diabetes Prevention Programme, measured 3 and 15 months after sending the text messages for practices in the intervention arm, or 15 months after the database search for practices in the control arm |
| Completion date | 01/09/2028 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 120 Years |
| Sex | Female |
| Target sample size at registration | 50 |
| Key inclusion criteria | General practices: 1. Practice has at least 5000 patients registered All practices will be asked to run a search of their patient records for women who meet the inclusion criteria and do not meet the exclusion criteria. The inclusion criteria are: 1. Women 2. Aged 18 years or over 3. Any history of GDM |
| Key exclusion criteria | The practices may not enter the study if the following apply: 1. Practice identifies less than 8 eligible patients 2. Practice currently sends reminders to women with a history of GDM to refer to the NHS-DPP 3. Taking part in another research study or service evaluation exploring the use of reminders to increase the uptake of NDPP to women with a history of GDM All practices will be asked to run a search of their patient records for women who meet the inclusion criteria and do not meet the exclusion criteria. The exclusion criteria are: 1. Recorded history of any other diabetes 2. Previously referred to or attended the NHS-DPP 3. Have a diagnosis of non-diabetic hyperglycaemia in the past 12 months 4. Have requested not to be contacted via SMS by their GP practice 5. Receiving palliative care 6. Have opted out of use of their data for research purposes 7. Any other reason for which the GP practice judges it is not appropriate to target the patient as part of this trial |
| Date of first enrolment | 27/07/2026 |
| Date of final enrolment | 01/05/2027 |
Locations
Countries of recruitment
- United Kingdom
Study participating centres
High Heaton
Newcastle upon Tyne
NE7 7DN
England
Leeds
LS9 7TF
England
Oxford Road
Manchester
M13 9WL
England
Leicester
LE1 5WW
England
Heath Town
Wolverhampton
WV10 0QP
England
Colney
Norwich
NR4 7UY
England
80 Newark Street
London
E1 2ES
England
Westminster Bridge Road
London
SE1 7EH
England
Southampton
SO16 6YD
England
Guildford
GU2 7XX
England
Marlborough Street
Bristol
BS1 3NU
England
Exeter
EX2 5DW
England
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Editorial Notes
03/11/2025: Trial's existence confirmed by the National Institute for Health and Care Research (NIHR) (UK).
