Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders

Abstract

Objective There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. Design A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. Methods Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90% during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. Results In intention-to-treat analysis, 53% of participants receiving weekly SMS reminders achieved adherence of at least 90% during the 48 weeks of the study, compared with 40% of participants in the control group (P=0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90%, P = 0.03). Conclusion These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.

Strategies to improve follow-up of children after surgery for cataract: findings from Child Eye Health Tertiary Facilities in sub-Saharan Africa and South Asia

“…Given the significant cost 16 associated with surgical interventions, the effort to obtain good-quality follow-up is minimal. [17][18][19] Summary What was known before K Initial work in Tanzania identified reasons for poor follow-up. K There is limited information on educational placement following sight-restoring or sight-improving surgery in children.…”

The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review

“…3,18 Data from developing countries have highlighted the impact of mobile technology on communicable diseases, such as tuberculosis, human immunodeficiency virus, and malaria. [19][20][21][22] However, to communication and short message service [SMS]) on chronic disease outcomes in LMIC.…”

Usability of a CKD Educational Website Targeted to Patients and Their Family Members

“…Providers using health IT to connect with their patients may improve overall patient-provider communication and also help to promote patient autonomy and empower patients' with management of their own health. Providers using health IT tools to communicate with patients have reported improved medication adherence and appointment compliance for various ailments (4,(23)(24)(25)(26). Whether health IT applications are preferred by patients and whether a broader disease population can effectively use and benefit from such devices remain unclear.…”