Mobile Health Technologies May Be Acceptable Tools for Providing Social Support to Tuberculosis Patients in Rural Uganda: A Parallel Mixed-Method Study

Abstract

Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking. Objective. To explore TB patients’ current access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for ≥1 month, were receiving their treatment from Mbarara Regional Referral Hospital, and reported having ≥1 social supporter. We interviewed these patients and their social supporters about their access to and perceptions of social support. We used STATA 13 to describe participants’ sociodemographic and social support characteristics. Qualitative data were analyzed using content analysis to derive categories describing accessibility and perceptions. Results. TB patients report requesting and receiving a variety of different forms of social support, including instrumental (e.g., money for transport and other needs and medication reminders), emotional (e.g., adherence counselling), and informational (e.g., medication side effects) support through mobile phones. Participants felt that SMS notifications may motivate medication adherence by creating a personal sense of obligation to take medications regularly. Participants anticipated that limited financial resources and relationship dynamics could constrain the provision of social support especially when patients and social supporters are not oriented about their expectations. Conclusion. Mobile telephones could provide alternative approaches to providing social support for TB medication adherence especially where patients do not stay close to their social supporters. Further efforts should focus on optimized designs of mobile phone-based applications for providing social support to TB patients and training of TB patients and social supporters to match their expectations.

The Promise and Peril of Mobile Phones for Youth in Rural Uganda: Multimethod Study of Implications for Health and HIV

“…More generally, several systematic reviews have shown that there is substantial evidence for the utility of mobile phone reminders to improve antiretroviral therapy adherence for people living with HIV in East Africa [ 14 , 15 ]. Studies in Uganda suggest that SMS text messaging is also a feasible and acceptable platform to support tuberculosis medication adherence [ 16 , 17 ] and testing [ 18 , 19 ]. Given the rapid rise in mobile phone ownership and the types of phones available and the importance of tailored interventions, there is a pressing need to examine the current state of mobile phones among AYAs in East Africa.…”

Enhancing Tuberculosis Care in Southwestern Uganda: Facilitators and Barriers to Utilizing Mobile Health Technologies

“…The use of mobile health technologies (e.g., smartphone apps, text messages, wearable devices) in supporting tuberculosis care is highly recommended by the World Health Organization as an emerging opportunity that can close the gaps in tuberculosis care (World Health Organization, 2019). Although their application in tuberculosis care in developing countries is still in its infancy, there is some evidence that they can enhance tuberculosis care through screening and case notification (Tumuhimbise & Musiimenta, 2021a), motivating treatment adherence (Musiimenta et al, 2018(Musiimenta et al, , 2019, fostering prenatal service utilization (Musiimenta et al, 2020a(Musiimenta et al, , b, 2021Tumuhimbise et al, 2020), and providing social support to tuberculosis patients (Musiimenta et al, 2020a, b). Mobile health technologies are low-cost applications that can potentially be sensitive to both the private sector ways of working and the expectations of the national tuberculosis programs (Uplekar, 2016), with the ability to produce tremendous results in facilitating the engagement of the private hospitals.…”

The Role of Nurses in Providing Social Support in Tuberculosis Treatment: Literature Review

“…According to research conducted in Uganda, the use of smartphones as a communication medium provides different social support, namely by providing emotional support, instrumental support, and information via smartphones, besides notifications on smartphones can provide motivation in treatment adherence by creating a sense of obligation to tuberculosis patients to drink. medicine regularly and on time (Musiimenta et al, 2020). In addition to providing support in the form of health information and providing emotional support that will help patients cope with stress, nurses also have a role in providing information and working with the patient's family to monitor taking medication (Munali, Kusnanto, Hanik Endang Nihayati, Hidayat Arifin, 2019).…”