Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers.
Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers.
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DOI：
10.1371/journal.pone.0176051
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Klein GO
中科院分区：
文献类型：
--
作者：
Nhavoto JA;Grönlund Å;Klein GO
然而，发展中国家已进行了一些研究，使用短信与患者沟通，以减少错过预约的次数并提高治疗的保留率；很少有规模得到扩大。造成这种情况的一个可能原因可能是患者或工作人员在某种程度上对该方法不满意。本文报告了一项关于患者和医护人员 (HCW) 对移动医疗干预措施看法的研究，该干预措施旨在支持莫桑比克保留抗逆转录病毒治疗 (ART) 和结核病 (TB) 治疗。该研究是在莫桑比克的五个医疗中心进行的。在随机对照试验中，向患者发送自动短信健康宣传和提醒。总共采访了 141 名患者和 40 名医护人员。受访者使用李克特量表问卷对 SMS 系统的有用性、感知收益、易用性、满意度和风险进行了评分。随后是半结构化面试指南。采访内容被转录并进行了主题分析。患者和医护人员都发现短信系统有用且可靠。最受好评的积极效果是减少取药失败的次数并避免错过预约。患者对该系统的信心很高。大多数人认为该系统可以改善医疗保健提供者和患者之间的沟通，并有助于教育和激励。自动识别患者的问题并提供适当的答案（该系统的独特功能）尤其受到赞赏。大多数人会向其他患者或医疗中心推荐该系统。大多数医护人员还提到了患者使用共用电话时无意泄露健康状况的风险。结果表明，针对艾滋病毒和结核病的短信技术应用于传输预约提醒、药物治疗、励志文本和健康教育，以提高护理的保留率。必须采取措施降低隐私侵犯的风险，但这并不是扩大此类系统的主要障碍。
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. 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. 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. 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.