Effects of a Mobile Phone Effects of a Mobile Phone Short Message Service Short Message Service (SMS) on Antiretroviral (SMS) on Antiretroviral Treatment Adherence in Treatment Adherence in Kenya (WelTel Kenya1): A Kenya (WelTel Kenya1): A Randomized Trial Randomized Trial Jesse Coleman University of British Columbia, BC Centre for Disease Control ICIUM, Antalya, Turkey Nov 14, 2011 Original research by Dr. Richard Lester et al. Your health, in your hands
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Effects of a Mobile Phone Short Message Service (SMS) on Antiretroviral Treatment Adherence in Kenya (WelTel Kenya1): A Randomized Trial Jesse Coleman.
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Effects of a Mobile Phone Short Effects of a Mobile Phone Short Message Service (SMS) on Message Service (SMS) on Antiretroviral Treatment Adherence in Antiretroviral Treatment Adherence in Kenya (WelTel Kenya1): A Randomized Kenya (WelTel Kenya1): A Randomized TrialTrial
Jesse ColemanUniversity of British Columbia, BC Centre for Disease Control
ICIUM, Antalya, Turkey Nov 14, 2011
Original research by Dr. Richard Lester et al.
Your health, in your hands
Kenya Clinic Survey, July 2005
• Despite often making <$2/day…
• Most patients Most patients attending HIV clinics had cell phone access had cell phone access
• Used for almost everything…• But not used for health
management
Lester et al. AIDS Vol 20, 17 Nov, 2006
The Unfortunate Gap
... Compared to the current standard of care (SOC)
The PHE: WelTel Kenya1Clinical Trial (NCT00830622)
*Protocol: SMS (text messaging)
SMS: “Mambo?= How RU?”
“Sawa” = Fine “Shida” = ProblemMonday
<48h
If necessary
HealthHealthAdviceAdvice
SMS ‘check-in’SMS ‘check-in’
SMS responseSMS response
*Derived from focused group discussions with HCW and patients
Study Participants and RandomizationStudy Participants and Randomization
ownership• Crisis management• Scalability?Scalability?• Why Why does it work?
– Behavior change?– Reminders?
Lester & Karanja Lancet Infectious Diseases Vol 8 December 2008
Study Conclusions• Cell phones useful for HIV/AIDS management
• SMS patient support significantly improved ART adherence and rates of viral suppression (First report)– SMS patients 24% more likely to be adherent to ART– SMS patients 19% more likely to have suppressed VL
• Logistical challenges can be overcome• May enhance equitable access equitable access to care
• Implications for developing health systems (horizontal?)http://www.scientificamerican.com/podcast/episode.cfm?id=text-message-outreach-improves-hiv-10-11-10