'I Wish to Continue Receiving the Reminder Short Messaging Service': A Mixed Methods Study on the Acceptability of Digital Adherence Tools Among Adults Living with HIV on Antiretroviral Treatment in Tanzania

Autor: Mirjam A. G. Sprangers, Kennedy Ngowi, Marion Sumari-de Boer, Pythia T. Nieuwkerk, Peter Reiss, Rob E. Aarnoutse, Francis Pima, Blandina T. Mmbaga
Přispěvatelé: Global Health, Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, Medical Psychology, APH - Personalized Medicine, APH - Mental Health
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Short Message Service
Psychological intervention
Human immunodeficiency virus (HIV)
Medicine (miscellaneous)
SMS reminders
medicine.disease_cause
real-time medication monitoring
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
acceptability
Intervention (counseling)
050602 political science & public administration
medicine
Antiretroviral treatment
adherence
030212 general & internal medicine
Pharmacology
Toxicology and Pharmaceutics (miscellaneous)
Original Research
digital adherence tool
Service (business)
biology
business.industry
Health Policy
05 social sciences
DAT
biology.organism_classification
0506 political science
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]
Tanzania
Patient Preference and Adherence
Family medicine
business
ART
Social Sciences (miscellaneous)
Zdroj: Patient Preference and Adherence, 15, 559-568
Patient preference and adherence
Patient Preference and Adherence, 15, pp. 559-568
Patient preference and adherence, 15, 559-568. Dove Medical Press Ltd.
ISSN: 1177-889X
DOI: 10.2147/ppa.s290079
Popis: Kennedy Ngowi,1,2 Francis Pima,1 Blandina Theophil Mmbaga,1,3,4 Rob E Aarnoutse,5 Peter Reiss,6,7 Pythia T Nieuwkerk,2 Mirjam Sprangers,2 Marion Sumari-de Boer1 1Kilimanjaro Clinical Research Institute, Moshi, Tanzania; 2Amsterdam UMC, Location AMC, University of Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands; 3Kilimanjaro Christian Medical Center, Moshi, Tanzania; 4Kilimanjaro Christian Medical University College, Moshi, Tanzania; 5Radboudumc, Radboud Institute for Health Sciences & Department of Pharmacy, Nijmegen, The Netherlands; 6Amsterdam UMC, Location AMC, University of Amsterdam, Department of Global Health, And Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands; 7HIV Monitoring Foundation, Amsterdam, The NetherlandsCorrespondence: Kennedy NgowiKilimanjaro Clinical Research Institute, Moshi, TanzaniaTel +255758048649Email k.ngowi@kcri.ac.tzIntroduction: Digital Adherence Tools (DAT) to promote adherence to antiretroviral treatment (ART) for HIV are being increasingly adopted globally, however their effectiveness and acceptability in limited resource settings has been challenging. In this study, we examine the acceptability of DATs to improve adherence to ART.Methods: This study was part of a three-arm randomized controlled trial (REMIND) which investigated the effect of two different DAT’s: SMS text messages (SMS) or real-time medication monitoring (RTMM) on treatment adherence; compared to standard of care. Exit interviews and in-depth interviews were conducted at 48 weeks follow-up, to collect data on their experiences (successes, challenges, and barriers) and behaviours regarding the implementation of the interventions. Translated transcripts, memos and field notes were imported to NVivo software version 12. We used a thematic framework analysis which drew from Sekhon’s theoretical framework of acceptability (TFA), which comprises of seven constructs (affective attitude, perceived burden, perceived effectiveness, ethicality, self-efficacy, intervention coherence and opportunity costs).Results: Of the 166 participants enrolled, 143 (86%) were interviewed (68 in the SMS arm and 75 in the RTMM arm). Participants were highly satisfied (98%) with the DAT system and the majority of them reported it motivated them to take their medication (99%). The majority of participants reported they were confident in their ability to comply with the intervention and understood how the intervention worked (97%). Very few reported negatively about the devices (carrying the device), with only 6% reporting that they did not feel comfortable and 8% had ethical concerns with the SMS-content A few participants reported challenges with their connectivity/network and that the visits were too time-consuming. A few participants reported that they incurred extra cost for the sake of the study.Conclusion: Overall, the acceptability of these DATs was high. However, several factors may hamper their acceptability including the content and number of SMS, carrying the devices and the network availability.Keywords: adherence, SMS reminders, real-time medication monitoring, digital adherence tool, DAT, acceptability, ART
Databáze: OpenAIRE
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