The Acceptability of Adherence Support via Mobile Phones for Antituberculosis Treatment in South India: Exploratory Study (Preprint)

Abstract

UNSTRUCTURED India has the greatest burden of Tuberculosis (TB). But over 15% of the people on antitubercular therapy (ATT) in India are non-adherent. Several adherence monitoring techniques deployed in India to enhance ATT adherence have had modest effects. Increased adoption of mobile phones and other technologies pose potential solutions to measuring and intervening in ATT adherence. Several technology-based interventions around ATT adherence have been demonstrated in other countries. Given this potential, we sought to understand formative acceptance of mobile phone adherence supports for ATT using self-administered quantitative measures among 100 patients on ATT at the TB treatment Center (TTC) at a tertiary care center in Thrissur, Kerala, India. The participants were recruited using convenience sampling after obtaining written informed consent. Trained study staff administered the questionnaire in the local language of the participant. Of the 100 participants diagnosed with TB on directly observed treatment short course (DOTS), 90% used mobile phones routinely, and 84% owned a mobile phone. Ninety-five percent knew how to use the calling function, while 65% did not know how to use the SMS function on their mobile phone. Overall, 89% of the participants did not consider mobile phone-based ATT adherence interventions an intrusion in their privacy; 93% did not fear stigma if the adherence reminder was received by someone else. Most (95%) of the study participants preferred mobile phone reminders instead of DOTS. The most preferred reminder modality was voice calls (N=80, 80%) compared to SMS reminders (N=5, 5%). We found a high uptake of mobile phones among patients with TB in India. Preference of voice call reminders among the participants should be considered and strengthening the current adherence monitoring system is deemed appropriate. Future ATT adherence interventions should consider integrating mobile phone based daily reminders.

Formative acceptance of ingestible biosensors to measure adherence to TB medications: An exploratory study

“…HIV pre-exposure prophylaxis), researchers should incorporate key cultural underpinnings of adherence monitoring in India, as well as mobile phone literacy, which may de ne both the platform and content of ATT adherence interventions in India. [22,23] There are several limitations in this study. First, due to the pilot nature of this study, the sample was small and primarily located in Kerala, India.…”