In-Depth Analysis of Patient-Clinician Cell Phone Communication during the WelTel Kenya1 Antiretroviral Adherence Trial

Details

• Alternative Title:
  PLoS One
• Personal Author:
  van der Kop, Mia L. ; Karanja, Sarah ; Thabane, Lehana ; Marra, Carlo ; Chung, Michael H. ; Gelmon, Lawrence ; Kimani, Joshua ; Lester, Richard T.
• Description:
  Background ; The WelTel Kenya1 trial demonstrated that text message support improved adherence to antiretroviral therapy (ART) and suppression of HIV-1 RNA load. The intervention involved sending weekly messages to patients inquiring how they were doing; participants were required to respond either that they were well or that there was a problem. ; Objectives ; 1) Describe problems participants identified through mobile phone support and reasons why participants did not respond to the messages; 2) investigate factors associated with indicating a problem and not responding; and 3) examine participant perceptions of the intervention. ; Design ; Secondary analysis of WelTel Kenya1 trial data. ; Methods ; Reasons participants indicated a problem or did not respond were extracted from the study log. Negative binomial regression was used to determine participant characteristics associated with indicating a problem and non-response. Data from follow-up questionnaires were used to describe participant perceptions of the intervention. ; Results ; Between 2007 and 2009, 271 participants generated 11,873 responses; 377 of which indicated a problem. Health issues were the primary reason for problem responses (72%). Rural residence (adjusted incidence rate ratio IRR 1.96; 95%CI 1.19–3.25; p = 0.009 and age were associated with indicating a problem (adjusted IRR 0.63 per increase in age group category; 95%CI 0.50–0.80; p<0.001). Higher educational level was associated with a decreased rate of non-response (adjusted IRR 0.81; 95%CI 0.69–0.94; p = 0.005). Of participants interviewed, 62% (n = 129) stated there were no barriers to the intervention; cell phone issues were the most common barrier. Benefits included reminding patients to take medication and promoting a feeling that “someone cares”. ; Conclusions ; The WelTel intervention enabled frequent communication between clinicians and patients during the WelTel Kenya1 trial. Many patients valued the service for the support it provided, with health-related concerns comprising the majority of problems identified by participants. Few sociodemographic characteristics were associated with participant engagement in the intervention.
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• Subjects:
  • Adult
  • Anti-HIV Agents
  • Cell Phones
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Text Messaging
  • Young Adult
• Source:
  PLoS One. 2012; 7(9).
• DOI:
  http://dx.doi.org/10.1371/journal.pone.0046033
• Pubmed ID:
  23049928
• Pubmed Central ID:
  PMC3457960
• Document Type:
  Journal Article
• Funding:
  5U62PS024510/PS/NCHHSTP CDC HHS/United States ; PEPFAR/United States
• Corporate as Subject:
  United States. President's Emergency Plan For AIDS Relief (PEPFAR)
• Place as Subject:
  Kenya
• Volume:
  7
• Issue:
  9
• Download URL:
  https://stacks.cdc.gov/view/cdc/22687/cdc_22687_DS1.pdf
• File Type:
  [PDF - 182.55 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:acdc2cb279849d7cc5687a0e11245bfd48f3fa450089c463406af1b01e403591796bb756d24b95c7017f54ca044133ff7e4d2d22d00453b7871da083aed7457d