Informatics, School of Business, Örebro University, Örebro, Sweden.
Informatics, Department of Mathematics and Informatics, Eduardo Mondlane University, Maputo, Mozambique.
PLoS One. 2017 Apr 18;12(4):e0176051. doi: 10.1371/journal.pone.0176051. eCollection 2017.
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.
一些发展中国家开展了使用短信与患者进行沟通的研究，以减少预约失约次数并提高治疗保留率，但这些研究很少得到推广。一个可能的原因是患者或工作人员在某些方面对该方法不满意。本文报告了一项针对莫桑比克艾滋病毒和结核病（TB）治疗保留率支持的 mHealth 干预措施的患者和医疗保健工作者（HCW）意见的研究。
该研究在莫桑比克的五个医疗中心进行。在 RCT 中向患者发送自动化的短信健康宣传和提醒。共有 141 名患者和 40 名 HCW 接受了访谈。受访者使用李克特量表问卷对短信系统的有用性、感知收益、易用性、满意度和风险进行了评分。采用半结构化访谈指南进行访谈。访谈记录被转录并进行了主题分析。
患者和 HCW 均认为短信系统有用且可靠。大多数高度评价的积极影响是减少未取药和避免失约的次数。患者对系统的信心很高。大多数人认为该系统可以改善医患之间的沟通，并有助于教育和激励。系统自动识别患者的问题并提供适当的答案（这是该系统的独特功能）特别受到赞赏。大多数人会向其他患者或医疗中心推荐该系统。HCW 主要提到了一些风险，即在患者使用共享电话的情况下，无意中泄露健康状况。
结果表明，应使用 HIV 和 TB 的短信技术来发送预约、药物、激励文本和健康教育提醒，以提高护理保留率。必须采取措施降低隐私侵犯的风险，但这不是扩大此类系统规模的主要障碍。
