Hardy Victoria, Hsieh Jenny, Chirambo Baxter, Wu Tsung-Shu Joseph, O'Donoghue John, Muula Adamson S, Thompson Matthew
Department of Family Medicine, University of Washington, Seattle, Washington, USA.
Luke International (LIN), Malawi Office, Mzuzu, Malawi.
Malawi Med J. 2017 Mar;29(1):53-54. doi: 10.4314/mmj.v29i1.10.
Patient follow-up is a routine component of clinical practice and valuable for evaluating the effectiveness of interventions, but because of the broad dispersion of health facilities and lack of standardised medical reporting in Malawi, collecting patient outcome data can be challenging. Increasing accessibility and affordability of mobile technology in resource-poor settings may facilitate patient follow-up in the community. The objective of this study was to evaluate the potential utility of mobile phones for collecting follow-up clinical data from parents or caregivers of acutely unwell under-5 children, for intervention evaluation purposes.
Parents' or caregivers' mobile phone numbers were obtained by health surveillance assistants (HSAs) during study enrollment. Guardians who provided a telephone number were contacted by the study team to establish re-consultations or hospitalisations of their child(ren) within 14 days of recruitment. Health records at village clinics and higher-level health facilities were hand-searched to identify or confirm presentations and abstract clinical data.
87 out of 149 (58.4%) guardians provided a mobile telephone number, of whom the study team could contact 44 (29.5%). Seven guardians stated they took their child for further treatment: three of these returned to village clinics and four presented to secondary care facilities; attendance could only be confirmed from health records for one child.
With continued expansion of cellular network coverage and mobile ownership in Malawi, mobile phones may facilitate collection of patient outcomes for intervention evaluation purposes. Future consideration should also be given to integrating mobile technologies into HSA clinical practice.
患者随访是临床实践的常规组成部分，对于评估干预措施的有效性很有价值，但由于马拉维卫生设施分布广泛且缺乏标准化的医疗报告，收集患者结局数据可能具有挑战性。在资源匮乏地区，移动技术的可及性和可承受性不断提高，这可能有助于在社区进行患者随访。本研究的目的是评估手机在收集5岁以下急性不适儿童的父母或照顾者的随访临床数据以用于干预评估方面的潜在效用。
在研究入组期间，健康监测助理（HSAs）获取了父母或照顾者的手机号码。研究团队联系了提供电话号码的监护人，以确定他们的孩子在招募后14天内是否再次咨询或住院。手工查阅了乡村诊所和上级卫生设施的健康记录，以识别或确认就诊情况并提取临床数据。
149名监护人中有87名（58.4%）提供了手机号码，其中研究团队能够联系到44名（29.5%）。7名监护人表示他们带孩子去接受了进一步治疗：其中3人返回了乡村诊所，4人前往二级医疗机构就诊；只有一名儿童的就诊情况能够从健康记录中得到确认。
随着马拉维蜂窝网络覆盖范围和手机拥有量的持续扩大，手机可能有助于收集患者结局数据以用于干预评估。未来还应考虑将移动技术整合到健康监测助理的临床实践中。
