Using Mobile Phones to Improve Clinic Attendance Amongst an Antiretroviral Treatment Cohort in Rural Uganda: A Cross-sectional and Prospective Study
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We aimed to assess the patterns and dynamics of mobile phone usage amongst an antiretroviral treatment (ART) cohort in rural Uganda and ascertain its feasibility for improving clinic attendance. A cross-sectional study of clients on ART exploring their access to mobile phones and patterns of use was employed. Clinic attendances for antiretroviral drug refills were then monitored prospectively over 28 weeks in 176 patients identified in the cross-sectional survey who had access to mobile phones and had given consent to be contacted. Patients were contacted via voice calls or text messages to remind them about their missed clinic appointments. Of the 276 patients surveyed, 177 (64%) had access to mobile phones with all but one were willing to be contacted for missed visits reminders. Of the 560 total scheduled clinic appointments, 62 (11%) were missed visits. In 79% of episodes in which visits were missed, patients presented for treatment within a mean duration of 2.2 days (SD = 1.2 days) after mobile phone recall. Access to mobile phones was high in this setting. Privacy and confidentiality issues were not considered deterrents. Mobile phones have a potential for use in resource-constrained settings to substantially improve the clinical management of HIV/AIDS.
KeywordsAdherence Attendance Anti-retroviral therapy Mobile phones HIV AIDS
We acknowledge the support of the Ugandan National AIDS Control Programme in facilitating this study. The study team also acknowledges the contributions of clients on ART at the various sites. We particularly thank the Research Assistant, Nicholas Ssendege and the adherence workers namely Solomy Kataabu, Josephine Mirembe, Isaac Buzaka and Loyce Babirye for their immense contribution during data collection. We also thank the management and health workers of the health facilities where these surveys were conducted. The study was conducted by the Department for International Development (DFID) funded Communicable Disease Research Programme (COMDIS), Nuffield Centre for International Health and Development, Leeds University, United Kingdom.
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