Mobile health treatment support intervention for HIV and TB in Mozambique: Perspectives of patients and healthcare workers
Abstract
Background
Studies have been
conducted in developing countries using SMS to communicate with
patients to reduce the number of missed appointments and improve
retention in treatment, however; very few have been scaled up.
One possible reason for this could be that patients or staff are
dissatisfied with the method in some way. This paper reports a
study of patients’ and healthcare workers’ (HCW)
views on an mHealth intervention aiming to support retention in
antiretroviral therapy (ART) and tuberculosis (TB) treatment in
Mozambique.
Methods
The study was conducted at
five healthcare centres in Mozambique. Automated SMS health
promotions and reminders were sent to patients in a RCT. A total
of 141 patients and 40 HCWs were interviewed. Respondents rated
usefulness, perceived benefits, ease of use, satisfaction, and
risks of the SMS system using a Likert scale questionnaire. A
semi-structured interview guide was followed. Interviews were
transcribed and thematic analysis was conducted.
Results
Both patients and HCW found
the SMS system useful and reliable. Most highly rated positive
effects were reducing the number of failures to collect
medication and avoiding missing appointments. Patients’
confidence in the system was high. Most perceived the system to
improve communication between health-care provider and patient
and assist in education and motivation. The automatic
recognition of questions from patients and the provision of
appropriate answers (a unique feature of this system) was
especially appreciated. A majority would recommend the system to
other patients or healthcare centres. Risks also were mentioned,
mostly by HCW, of unintentional disclosure of health status in
cases where patients use shared phones.
Conclusions
The results suggest that
SMS technology for HIV and TB should be used to transmit
reminders for appointments, medications, motivational texts, and
health education to increase retention in care. Measures must be
taken to reduce risks of privacy intrusion, but these are not a
main obstacle for scaling up systems of this kind.
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Source:
PLOS ONE
