Abstract
BackgroundClinical trials were conducted to assess the feasibility of using a cell phone text messaging-based system to follow up Human Immunodeficiency Virus (HIV) infected patients on antiretroviral (ARTs) and assess for improved adherence to their medication. However there is need to evaluate the perceptions of the HIV infected patients towards the use of these cell phones in an effort to better aid in the clinical management of their HIV infection. The objective of this study was therefore to determine the perceptions of HIV infected patients on the use of cell phone text messaging as a tool to support adherence to their ART medication.MethodsA cross sectional survey was conducted among patients receiving Highly Active Anti-Retroviral Therapy (HAART) at the Kenyatta National Hospital Comprehensive Care Clinic in Nairobi between May and July, 2011. Pre-tested questionnaires were used to collect the socio-demographic and perceptions data. The recruitment of the participants was done using the random probability sampling method and statistical analysis of data performed using Statistical Package for Social Sciences (SPSS) version 16.0.ResultsA total of 500 HIV infected patients (Male-107, Female-307) aged 19-72 years were interviewed. The majority of individuals (99%) had access to cell phones and 99% of the HIV infected patients interviewed supported the idea of cell phone use in management of their HIV infection. A large proportion (46%) claimed that they needed cell phone access for medical advice and guidance on factors that hinder their adherence to medication and only 3% of them needed it as a reminder to take their drugs. The majority (72%) preferred calling the healthcare provider with their own phones for convenience and confidential purposes with only 0.4% preferring to be called or texted by the health care provider. Most (94%), especially the older patients, had no problem with their confidentiality being infringed in the process of the conversation as per the bivariate analysis results.ConclusionCell phone communications are acceptable and in fact preferable over cell phone reminders.
Highlights
Clinical trials were conducted to assess the feasibility of using a cell phone text messaging-based system to follow up Human Immunodeficiency Virus (HIV) infected patients on antiretroviral (ARTs) and assess for improved adherence to their medication
We present odds ratios (OR), and 95% Confidence Interval (CI) for factors associated with cell phone access and perceptions towards its use as a tool to support ARV adherence
Respondents’ cell phone accessibility and perceptions towards cell phone use as a tool for supporting antiretroviral therapy (ART) adherence This study reported almost 99% access to cell phone with majority (77%) of those interviewed using the alarm function on their phones for waking up as compared to only 15% that used it as a reminder to take their medications (Table 1)
Summary
Clinical trials were conducted to assess the feasibility of using a cell phone text messaging-based system to follow up Human Immunodeficiency Virus (HIV) infected patients on antiretroviral (ARTs) and assess for improved adherence to their medication. The World Health Organization (WHO) intensified their advocacy on the provision of antiretroviral therapy (ART) to reduce Acquired Immuno Deficiency Syndrome (AIDS)related deaths and alleviate fears about HIV in the year 2003 [1] In embracing this advocacy, Kenya expanded its ART coverage tremendously with percentage of adults receiving ART increasing from 55.3% in the year 2008 to 70.4% in the year 2009 [2]. Technology innovations in Kenya have been increasing tremendously with the Communication Council of Kenya (CCK) report of 2010 [5] describing a mobile phone penetration rate of 39% with sharp concentrations of 70% found within the urban centers where HIV prevalence has been reported to be high [6] This prompted more effort into health research to seek the possibility of mobile phones solving the challenge of decreasing adherence to ART medication
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