In developed countries, only half of people with chronic illnesses take their medications as prescribed, and this number can be even lower for people with low health literacy skills, poor social supports or unstable housing.
So when Dr. Richard Lester and his team started one of the early HIV treatment programs in Kenya, they knew they needed to find a low-cost way to support patients to take their medicine, and take it correctly.
“We started by brainstorming with clinicians and patients and quickly found out that patients don’t want to be reminded to take their medication, they want to feel supported,” says Lester, an associate professor in the University of British Columbia’s Division of Infectious Diseases.
“Adherence is about more than just remembering to take your pills, it’s about the other priorities in your life – addictions, childcare, mental health – and how you balance all of these factors.”
The result was WelTel, a weekly text messaging service that makes use of widespread cell phone access in Kenya to simply ask ‘Mambo?’ (‘How are you?’ in Kiswahili).
According to Lester, a friendly ‘How are you?’ works because it isn’t intrusive, but it opens the door to support if and when it is needed, without raising suspicion or sharing confidential information.
Halfway around the world, at BC Women’s Hospital’s Oak Tree Clinic, outreach nurses use similar weekly text messages to stay in touch with vulnerable patients. The clinic provides care for women and children living with HIV/AIDS across British Columbia.
“The texts help build a bond between patient and nurse. Even though the first message is automated, patients know that there is a person at the other end who is there to help them,” says Dr. Melanie Murray, an infectious disease physician based at the Oak Tree Clinic.
“It gives users the opportunity to ask for the support they need, whether that is ‘I need to reschedule my appointment’ or ‘I have nothing to eat.’”
Although patients still might not show up for their scheduled appointments, staying in contact gives clinicians the chance to identify and address problems related to treatment, or societal factors that impact physical and mental well-being, before they escalate into crises.
For Lester and his team, the next step is analyzing the hundreds of thousands of text messages they’ve gathered and putting them to work to improve health services.
“The great thing about text messaging is that with relatively simple technology we can offer support to a large patient population and make better use of in-person visits.
“Initially, we focused on HIV and tuberculosis, but this approach can be applied globally for almost any condition, and has already expanded to include maternal child health programs in Kenya, and chronic disease care in Haida Gwaii.”
This piece was originally published by the Michael Smith Foundation for Health Research, British Columbia’s health research funding agency. Read the original post here.