Abstract
Background:In resource-limited settings, many HIV-infected patients with advanced HIV-related disease need specialized care not represented in guidelines. Training opportunities for healthcare providers on advanced HIV care are limited. The aim of this study was to evaluate the educational content and acceptability of mobile instant messaging (MIM) as a training and telemedicine tool for HIV care providers in Malawi.Methods:At the Lighthouse Clinic, Malawi, a MIM group using WhatsApp® was created for clinical officers and moderated by an infectious disease consultant. Questions encountered in the clinics as well as educational cases were posted; identifying data was not to be posted. MIM conversation was analyzed and in-depth interviews with users on its perceptions were performed.Results:MIM was utilized by 25 clinical officers and five physicians with an average of 2.3 threads/week over the observation period of 15 months. Discussed topics related to tuberculosis (25 threads), adverse drug reaction (22 threads), antiretroviral treatment (21 threads), cryptococcal meningitis (12 threads), and drug dosing/logistics. In 20% of the threads at least one image file was shared (mainly pictures of skin conditions and chest X-rays). In-depth interviews showed that clinical officers appreciated MIM group as a telemedicine consulting and training tool.Conclusion:MIM was a successful and well-accepted telemedicine tool for support and training of clinical officers providing HIV care in a resource-limited setting. MIM may be integrated in training strategies to expand the knowledge of HIV care providers.
Highlights
An encouraging decline in the prevalence of advanced HIV disease at antiretroviral treatment (ART) initiation has been observed over recent years
This study describes the application and reception of a mobile instant messaging (MIM) group conversation for remote consultation and training on HIV-related patient conditions
Twenty-five members were clinical officers (COs) and five were physicians
Summary
A significant proportion of HIV patients still require complex management strategies due to severe immunosuppression, e.g., after late presentation or failing ART [2]. Guidelines increasingly recommend differentiated care models for patients with advanced HIV infection [3]. Patients with complex conditions require more individualized management as they present with opportunistic infections, HIV-associated cancers, drug side effects, and high viral loads. Non-communicable diseases further complicate the long-term management of HIV patients [4]. In resource-limited settings, many HIV-infected patients with advanced HIVrelated disease need specialized care not represented in guidelines. Training opportunities for healthcare providers on advanced HIV care are limited. The aim of this study was to evaluate the educational content and acceptability of mobile instant messaging (MIM) as a training and telemedicine tool for HIV care providers in Malawi
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