For patients with HIV, text message reminders may improve their adherence

Deliver better healthcare through effective use of secure mobile messaging

Communication via text messages helps improve patient care for conditions such as HIV in low-income countries, a study suggests.

“Patients who received text messages felt that their doctor cared and the method proved to be significant in getting people to show up for their appointments,” said study author José António Nhavoto.

For the thesis project, investigators sought to examine how text messages could be used in different ways to improve patient care in 16 health centers in the Maputo region of Mozambique.

“The patients were undergoing treatment for HIV/AIDS or tuberculosis, diseases with among the highest mortality rate in the country,” António Nhavoto said. “In addition, these diseases are stigmatizing.”

The results of the study showed that the number of missed physician’s appointments dramatically declined from 1 of 4 to nearly none. The findings were based on a patient group of 50,000 individuals.

Four different types of text messages were linked to the treatments in the study. Two of the messages were reminders for appointments and picking up prescriptions. The third was aimed at motivating and encouraging patients to follow their treatment regimens.

“The fourth message category focused on information, for example on how to avoid having others catch the disease and the possibility to test for HIV for free,” António Nhavoto said.

Although all the text messages were anonymous, they were personal in content and based on the medical records of the individual patients. The findings showed that the text messages appeared to improve care for both patients and the health care staff.

“The technology used is cheap and easy to scale up,” António Nhavoto said. “It can be used for other diseases and in other countries. In India, mobile phones are widely used. Even in affluent countries such as Sweden, where many people own much more advanced phones, voice messaging or even video may well be a development of what we have done here.”

Although harnessing text message technology in poor countries has advantages––such as low-costs and cell phones are relatively common––there are still several obstacles to overcome.

“Women in rural areas in Mozambique are not allowed mobile phones so they are relying on their husbands,” António Nhavoto said. “Neither do health care centers in certain areas have any computers, since there is no electricity. What people do have, however, is the possibility to charge their phones.”

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