Increasing Awareness of the Importance of Reporting Adverse Drug Reactions of Antiretroviral Drugs Among Adults Living with HIV in Moshi, Tanzania: A Pilot Study on Using SMS Reminders for Reporting

Abstract

Introduction: In Sub-Saharan Africa, there are knowledge gaps on adverse drug reactions (ADRs) of antiretroviral treatment (ART). Studies have shown that limited training capacity among healthcare workers has affected reporting of ADRs and weakened the pharmacovigilance system in Tanzania. Studies have shown that the use of digital tools, including SMS communication, might be a viable way to increase knowledge and understanding of reporting ADRs. This study aimed to examine the acceptability and feasibility of SMS texts to increase awareness about the importance of reporting ADRs of ART among people living with HIV (PLHIV) in Tanzania. We also explored different ADR profiles that were reported by the participants. Methodology: This was a prospective implementation pilot study. PLHIV who consented to the study received a biweekly message to ask them how they were doing. We programmed keywords in the system that could be used for responding to the presence of ADR. The response to messages generated a flow of SMS that determined the presence of ADRs and informed participants to report. The technical feasibility was calculated based on the percentages of SMS which were sent and delivered about ADR and acceptability was measured based on the percentage of SMS that was replied to by the participants. We also collected data on different types of ADR reported by the participants. We conducted focus group discussions with participants and in-depth interviews with health workers to understand their experiences with and acceptability of the system. Results: Over a 12-month study period, a total of 92 participants were recruited. Sixty-two (67.4%) were women. The mean age of our participants was 42 years (SD 12). Forty (43.5%) participants were on ART for less than 3 months and the other 52 (56.5%) participants were on first-line ART. The system successfully sent and delivered 105 follow-up messages to all participants who consented to receive SMS. Among all the sent SMS 100 (95.2%) were replied to by the participants. Commonly reported ADRs were itching, gastrointestinal discomfort, joint pain, malaise and headache. The themes identified through FGD and IDI were: high motivation to report ADR, well-understood SMS content, the system to remain the same, no concerns about unwanted disclosure, and difficulties in replying to SMS due to network. The latter was mentioned by a few participants. Conclusion: SMS for creating awareness on ADRs reporting is a user-friendly intervention and highly accepted based on qualitative data among PLHIV in Tanzania. Also use of SMS is a low-cost intervention and a simple way to improve public health issues with society. Keywords: Short Message Services; Adverse drug reactions; Awareness; Acceptability