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Challenges in Using Mobile Phones for Collection of Antiretroviral Therapy Adherence Data in a Resource-Limited Setting

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Abstract

Frequent antiretroviral therapy adherence monitoring could detect incomplete adherence before viral rebound develops and thus potentially prevent treatment failure. Mobile phone technologies make frequent, brief adherence interviews possible in resource-limited settings; however, feasibility and acceptability are unknown. Interactive voice response (IVR) and short message service (SMS) text messaging were used to collect adherence data from 19 caregivers of HIV-infected children in Uganda. IVR calls or SMS quantifying missed doses were sent in the local language once weekly for 3–4 weeks. Qualitative interviews were conducted to assess participant impressions of the technologies. Participant interest and participation rates were high; however, weekly completion rates for adherence queries were low (0–33%), most commonly due to misunderstanding of personal identification numbers. Despite near ubiquity of mobile phone technology in resource-limited settings, individual level collection of healthcare data presents challenges. Further research is needed for effective training and incentive methods.

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References

  1. World Health Organization. Toward universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress Report 2009, WHO Press: Geneva.

  2. Ickovics JR, Cameron A, Zackin R, et al. Consequences and determinants of adherence to antiretroviral medication: results from adult AIDS clinical trials group protocol 370. Antivir Ther. 2002;7(3):185–93.

    PubMed  Google Scholar 

  3. Lima VD, Harrigan R, Bangsberg DR, et al. The combined effect of modern highly active antiretroviral therapy regimens and adherence on mortality over time. J Acquir Immune Defic Syndr. 2009;50(5):529–36.

    Article  CAS  PubMed  Google Scholar 

  4. Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10(3):227–45.

    Article  PubMed  Google Scholar 

  5. Nieuwkerk PT, Oort FJ. Self-reported adherence to antiretroviral therapy for HIV-1 infection and virologic treatment response: a meta-analysis. J Acquir Immune Defic Syndr. 2005;38(4):445–8.

    Article  PubMed  Google Scholar 

  6. Parienti JJ, Das-Douglas M, Massari V, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS One. 2008;3(7):e2783.

    Article  PubMed  Google Scholar 

  7. United Nations International Telecommunication Union, Measuring the information society—the ICT development index 2009. Available at: http://www.itu.int/ITU-D/ict/publications/idi/2009/material/IDI2009_w5.pdf. Access January 5, 2010.

  8. Beyond voice, in the economist. September 24, 2009.

  9. Schroder KE, Johnson CJ. Interactive voice response technology to measure HIV-related behavior. Curr HIV/AIDS Rep. 2009;6(4):210–6.

    Article  PubMed  Google Scholar 

  10. Schroder KE, Johnson CJ, Wiebe JS. Interactive voice response technology applied to sexual behavior self-reports: a comparison of three methods. AIDS Behav. 2007;11(2):313–23.

    Article  PubMed  Google Scholar 

  11. Corkrey R, Parkinson L. Interactive voice response: review of studies 1989–2000. Behav Res Methods Instrum Comput. 2002;34(3):342–53.

    PubMed  Google Scholar 

  12. Perrine MW, Mundt JC, Searles JS, Lester LS. Validation of daily self-reported alcohol consumption using interactive voice response (IVR) technology. J Stud Alcohol. 1995;56(5):487–90.

    CAS  PubMed  Google Scholar 

  13. Barta WD, Kiene SM, Tennen H, Abu-Hasaballah KS, Ferrer R. The idiographic study of inconsistent condom use behavior of persons living with HIV. AIDS Care. 2007;19(8):1058–64.

    Article  CAS  PubMed  Google Scholar 

  14. Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med. 2009;36(2):165–73.

    Article  PubMed  Google Scholar 

  15. CommCare-Community health mobile platform. Available from: http://www.dimagi.com/commcare/. Accessed January 6, 2010.

  16. Moca. Available from: http://www.mocamobile.org/. Accessed January 6, 2010.

  17. Haberer J, Mellins C. Pediatric adherence to HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2009;6(4):194–200.

    Article  PubMed  Google Scholar 

  18. Ybarra ML, Bull SS. Current trends in internet- and cell phone-based HIV prevention and intervention programs. Curr HIV/AIDS Rep. 2007;4(4):201–7.

    Article  PubMed  Google Scholar 

  19. Chang LW, Kagaayi J, Nakigozi G, et al. Responding to the human resource crisis: peer health workers, mobile phones, and HIV care in Rakai, Uganda. AIDS Patient Care STDS. 2008;22(3):173–4.

    Article  PubMed  Google Scholar 

  20. Curioso WH, Kurth AE. Access, use and perceptions regarding internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru. BMC Med Inform Decis Mak. 2007;7:24.

    Article  PubMed  Google Scholar 

  21. Abayomi A, Goodridge W, Asika O. Wireless networks for surveillance, data capture and data management in the human immunodeficiency virus epidemic care and treatment programmes. Afr J Med Med Sci. 2006;35(Suppl):149–52.

    PubMed  Google Scholar 

  22. Puccio JA, Belzer M, Olson J, et al. The use of cell phone reminder calls for assisting HIV-infected adolescents and young adults to adhere to highly active antiretroviral therapy: a pilot study. AIDS Patient Care STDS. 2006;20(6):438–44.

    Article  PubMed  Google Scholar 

  23. Project M. Available from: http://www.poptech.org/project_m. Accessed January 6, 2010.

  24. GSM World. Available from: http://www.gsmworld.com/cgi-bin/ni_map.pl?cc=ug&net=mt. Accessed January 8, 2010.

  25. Rent at Mobile Phone. Available from: http://www.rent-mobile-phone.com/images/maps/uganda_map.jpg. Accessed January 6, 2010.

  26. Lester RT, Mills EJ, Kariri A, et al. The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol. Trials. 2009;10:87.

    Article  PubMed  Google Scholar 

  27. Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114–6.

    Article  CAS  PubMed  Google Scholar 

  28. Ehiri JE, Anyanwu EC, Donath E, Kanu I, Jolly PE. AIDS-related stigma in sub-Saharan Africa: its contexts and potential intervention strategies. AIDS Public Policy J. 2005;20(1–2):25–39.

    PubMed  Google Scholar 

  29. Gaudine A, Glen L, Thuan TT, Dung do V. Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study. Int J Nurs Stud. 2010;47(1):38–48.

    Article  PubMed  Google Scholar 

  30. Intille SS. Ubiquitous computing technology for just-in-time motivation of behavior change. Stud Health Technol Inform. 2004;107(Pt 2):1434–7.

    PubMed  Google Scholar 

  31. Patrick K, Griswold WG, Raab F, Intille SS. Health and the mobile phone. Am J Prev Med. 2008;35(2):177–81.

    Article  PubMed  Google Scholar 

  32. VanDevanter N, Parikh NS, Cohall RM, et al. Factors influencing participation in weekly support groups among women completing an HIV/STD intervention program. Women Health. 1999;30(1):15–34.

    CAS  PubMed  Google Scholar 

  33. Rigsby MO, Rosen MI, Beauvais JE, et al. Cue-dose training with monetary reinforcement: pilot study of an antiretroviral adherence intervention. J Gen Intern Med. 2000;15(12):841–7.

    Article  CAS  PubMed  Google Scholar 

  34. Nachega JB, Leisegang R, Bishai D, et al. Association of antiretroviral therapy adherence and health care costs. Ann Intern Med. 2010;152(1):18–25.

    PubMed  Google Scholar 

  35. Mills EJ, Nachega JB, Buchan I, et al. Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA. 2006;296(6):679–90.

    Article  CAS  PubMed  Google Scholar 

  36. Vreeman RC, Wiehe SE, Pearce EC, Nyandiko WM. A systematic review of pediatric adherence to antiretroviral therapy in low- and middle-income countries. Pediatr Infect Dis J. 2008;27(8):686–91.

    Article  PubMed  Google Scholar 

  37. Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Glob Health. 2006;2:9.

    Article  Google Scholar 

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Acknowledgments

The study was funded by the National Institute of Mental Health (R21MH083306) and the Mark and Lisa Schwartz Family Foundation. The authors thank the participants, as well as the research staff in Mbarara, Uganda who collected and managed the study data: Nneka Emenyonu, Georgina Nakafero, Jenniffer Owomuhangi, Sarah Namwanje, Ambrose Mugenyi, Allen Kiconco, Dan Mwehire, Andrew Mugumemushabe, and Mathias Orimwesiga. They also greatly appreciate the technical assistance provided by Gerald Begumisa and Eric Lwanga at Yo! Voice Solutions and Jonathan Jackson and Cory Zue at Dimagi.

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Authors and Affiliations

  1. Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA

    Jessica E. Haberer

  2. Harvard Initiative for Global Health, 104 Mt. Auburn St, 3rd Floor, Cambridge, MA, 02138, USA

    Jessica E. Haberer & David R. Bangsberg

  3. Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Charlestown, MA, USA

    Jessica E. Haberer & David R. Bangsberg

  4. Department of Pediatrics, Mbarara University of Science and Technology, Kampala, Uganda

    Julius Kiwanuka & Denis Nansera

  5. Department of Medicine, Tufts University School of Medicine, Boston, MA, USA

    Ira B. Wilson

  6. Faculty of Medicine, Mbarara University of Science and Technology, Kampala, Uganda

    David R. Bangsberg

Authors
  1. Jessica E. Haberer
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  2. Julius Kiwanuka
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  3. Denis Nansera
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  4. Ira B. Wilson
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  5. David R. Bangsberg
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Correspondence to Jessica E. Haberer.

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Haberer, J.E., Kiwanuka, J., Nansera, D. et al. Challenges in Using Mobile Phones for Collection of Antiretroviral Therapy Adherence Data in a Resource-Limited Setting. AIDS Behav 14, 1294–1301 (2010). https://doi.org/10.1007/s10461-010-9720-1

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  • DOI: https://doi.org/10.1007/s10461-010-9720-1

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