MDR-TB Treatment & Prevention

Hello Sarah,
Recently I came across an interesting article (see link below) on the use of SMS text messaging related to both TB and HIV/AIDS treatments. The work was done in Malawi, and important findings and lessons learned from this effort may be replicable elsewhere. The contact e-mail addresses for more details are also included in that article.

Hope you find the article useful. Good wishes on your pilot study.

Paul

http://www.globalpulsejournal.com/pdfs/Mobiles%20in%20Malawi%20GP.pdf

Hi Sarah,

I just found a paper on Mobile Direct Observation Treatment for Tuberculosis Patients: A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya in the new issue of the American Journal of Preventive Medicine.

Unfortunately I cannot access full text but the abstract is below and I invited the corresponding author to the community to chime in on this in the hopes of learning more.

Hope this helps, Sophie

Mobile Direct Observation Treatment for Tuberculosis Patients: A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya

http://www.ajpm-online.net/article/S0749-3797(10)00259-X/abstract

Background

Growth in mobile phone penetration has created new opportunities to reach and improve care to underserved, at-risk populations including those with tuberculosis (TB) or HIV/AIDS.

Purpose

This paper summarizes a proof-of-concept pilot designed to provide remote Mobile Direct Observation of Treatment (MDOT) for TB patients. The MDOT model combines Clinic with Community DOT through the use of mobile phone video capture and transmission, alleviating the travel burden for patients and health professionals.

Methods

Three healthcare professionals along with 13 patients and their treatment supporters were recruited from the Mbagathi District Hospital in Nairobi, Kenya. Treatment supporters were asked to take daily ...

Hi Sarah,

I just found a paper on Mobile Direct Observation Treatment for Tuberculosis Patients: A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya in the new issue of the American Journal of Preventive Medicine.

Unfortunately I cannot access full text but the abstract is below and I invited the corresponding author to the community to chime in on this in the hopes of learning more.

Hope this helps, Sophie

Mobile Direct Observation Treatment for Tuberculosis Patients: A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya

http://www.ajpm-online.net/article/S0749-3797(10)00259-X/abstract

Background

Growth in mobile phone penetration has created new opportunities to reach and improve care to underserved, at-risk populations including those with tuberculosis (TB) or HIV/AIDS.

Purpose

This paper summarizes a proof-of-concept pilot designed to provide remote Mobile Direct Observation of Treatment (MDOT) for TB patients. The MDOT model combines Clinic with Community DOT through the use of mobile phone video capture and transmission, alleviating the travel burden for patients and health professionals.

Methods

Three healthcare professionals along with 13 patients and their treatment supporters were recruited from the Mbagathi District Hospital in Nairobi, Kenya. Treatment supporters were asked to take daily videos of the patient swallowing their medications. Patients submitted the videos for review by the health professionals and were asked to view motivational and educational TB text (SMS) and video health messages. Surveys were conducted at intake, 15 days, and 30 days. Data were collected in 2008 and analyzed in 2009.

Results

All three health professionals and 11 patients completed the trial. All agreed that MDOT was a viable option, and eight patients preferred MDOT to clinic DOT or DOT through visiting Community Health Workers.

Conclusions

MDOT is technically feasible. Both patients and health professionals appear empowered by the ability to communicate with each other and appear receptive to remote MDOT and health messaging over mobile. Further research should be conducted to evaluate whether MDOT (1) improves medication adherence, (2) is cost effective, and (3) can be used to improve treatment compliance for other diseases such as AIDS.

And just find a full evaluation report at this link: http://www.danya.com/files/MDOT%20Final%20Report.pdf for The Application of Telemedicine Technology to a Directly Observed Therapy Program for Tuberculosis: A Pilot Project

Hi Sarah,
You might find this evaluation about an SMS messaging in HIV in Africa interesting ([1] Bridges.org. Evaluation of the On Cue Compliance Service Pilot: Testing the use of SMS reminders in the treatment of Tuberculosis in Cape Town, South Africa. Cape Town: City of Cape Town Health Directorate and the International Development Research Council (IDRC); 2005, http://www.bridges.org/publications/11).

Also, I'm coming from the health IT community and we have had several discussions about how to implement different projects, in case you needed/wanted technical advise or possible collaborators on implementing the intervention.

Joaquin,
Thank you for your response. I have read this evaluation although I found
another that indicated that the intervention was abandon due to management
issues and there seems to be no formal write up on the study other than this
report. Also after much search it appears that On Cue changed to SimPill
(if I remember right?) and are marketing their product.
I would be interested in an IT perspective. I plan to use FrontlineSMS
software to manage text messages.
Thank you
Sarah

Paul,
Thank you very much for the article. I found it very interesting. I have
actually been in contact with one of the authors who is the executive
director for FronlineSMS. I plan to use this program in the intervention
but I had not yet come across this article.
Thanks
Sarah

Sophie,
Thank you very much for the lead on the article and the link to the report.
This is very helpful and I am excited to see more cell phone mediated
interventions coming out in TB treatment. I had read trial protocols for
antiretroviral therapy.
Sarah