Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study
Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study
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DOI：
10.1097/qai.0000000000001202
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发表时间：
2017-01-01
影响因子：
3.6
通讯作者：
Howard, Andrea A.
中科院分区：
文献类型：
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作者：
Hirsch-Moverman, Yael;Daftary, Amrita;Howard, Andrea A.
背景：移动健康是支持坚持治疗的一种有前途的手段。开始接受抗逆转录病毒治疗的结核病患者并继续接受治疗（START）研究包括使用短信服务（SMS）短信和经过培训的乡村卫生工作者（VHW）提供实时依从性支持。我们描述了移动健康的使用和接受艾滋病毒/结核病患者和health care providers.Methods：患者和治疗支持者收到自动化，编码的药物和预约提醒在他们喜欢的时间和频率，使用自己的手机，每月通话时间3.70美元。基于设施的VHW接受培训，将患者信息和文本消息偏好记录到移动的应用程序中，并获得密码保护的移动的电话和通话时间，以与基于社区的VHW进行通信。在研究过程中，从过程数据中分析了mHealth工具的使用情况。在每月对所有参与者进行随访时，以及在干预地点对30名患者和30名医疗保健提供者进行定性访谈时，对可接受性进行了评价。使用和可接受性的上下文每月坚持data.Findings：从2013年4月至2015年8月，自动短信系统成功地提供了39,528消息835个人，包括633名患者和202治疗支持者。短信干预的使用率很高，713名合格患者中有92.1%选择接收短信。患者和提供者的访谈深入了解移动健康利用的障碍和促进因素。干预措施提高了患者，治疗支持者和提供者之间的健康沟通质量。艾滋病毒相关的耻辱和技术挑战被确定为潜在的barriers.Conclusions：艾滋病毒/结核病治疗支持在莱索托的移动健康干预被认为是一个低技术，用户友好的干预，这是可以接受的病人和卫生保健提供者。
Background: mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers.Methods: Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data.Findings: From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers.Conclusions: The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, userfriendly intervention, which was acceptable to patients and health care providers.