A Qualitative Evaluation of the Acceptability of an Interactive Voice Response System to Enhance Adherence to Isoniazid Preventive Therapy Among People Living with HIV in Ethiopia

Abstract

Interactive voice response (IVR) is increasingly used to monitor and promote medication adherence. In 2014, we evaluated patient acceptability toward IVR as part of the ENRICH Study, aimed to enhance adherence to isoniazid preventive therapy for tuberculosis prevention among HIV-positive adults in Ethiopia. Qualitative interviews were completed with 30 participants exposed to 2867 IVR calls, of which 24% were completely answered. Individualized IVR options, treatment education, and time and cost savings facilitated IVR utilization, whereas poor IVR instruction, anticipated network and power malfunctions, one-way communication with providers, and delayed clinic follow-up inhibited utilization. IVR acceptability was complicated by HIV confidentiality, mobile phone access and literacy, and patient-provider trust. Incomplete calls likely reminded patients to take medication but were less likely to capture adherence or side effect data. Simple, automated systems that deliver health messages and triage clinic visits appear to be acceptable in this resource-limited setting.

Mobile phone‐based interactive voice response as a tool for improving access to healthcare in remote areas in Ghana – an evaluation of user experiences

“…Evidence highlights that IVR has proven to be a reliable and inexpensive tool in mobile healthcare. For instance, IVR has been applied in low‐ and middle‐income countries for remote education of health personal, for example in the field of family planning , for diagnostic and treatment support , to enhance medical adherence , for the management and monitoring of psychiatric conditions and mental health as well as for education and behaviour change communication in the field of sexually transmitted infections and chronic diseases . The results of our study contribute essential empirical findings to the neglected area of mHealth user acceptance in sub‐Saharan Africa.…”

Morbidity management and surveillance of lymphatic filariasis disease and acute dermatolymphangioadenitis attacks using a mobile phone-based tool by community health volunteers in Ghana

“…The use of mobile technology is a growing field in health surveillance [ 16 ], and has been used extensively as an intervention tool in many areas of the health sector in low- and middle-income countries for health promotion in the field of malaria [ 17 ], medical adherence [ 18 ] and treatment support [ 19 ], as well as for behavior change communication in chronic diseases [ 20 ]. Mobile technology has also been employed in other neglected tropical diseases, e.g.…”

Feasibility, acceptability and challenges of phone reminder system implementation for tuberculosis pill refilling and medication in Northwest Ethiopia

“…Text messages were often used for sending reminders [23][24][25][26][27], health-tips and other educational messages [2,3], and for maintaining users' awareness of their health goals [20]. Audio messages could be used for transferring messages to support TB treatment [28].…”