PO 8476 USER EXPERIENCE OF SMS REMINDERS TO TAKE MEDICATION AMONG PREGNANT AND BREASTFEEDING WOMEN LIVING WITH HIV IN KILIMANJARO, TANZANIA

Citation: 
1Kennedy M Ngowi*, 2Eusibious Maro, 3Pythia T Nieuwkerk, 4Rob E Aarnoutse, 1,2 Blandina T Mmbaga, 1,5I Marion Sumari-De Boer. 1Kilimanjaro Clinical Research Institute, Moshi, Tanzania; 3 Kilimanjaro Christian Medical Center, Moshi, Tanzania; Department of Medical Psychology, Academic Medical Center, Amsterdam, the Netherlands; Department of Pharmacy and with the Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, the Netherlands; 5 Department of International Health, Radboud UMC, Nijmegen, the Netherlands
Publication year: 
2019

Background

Pregnant women living with HIV have difficultiesin reaching adequate levels of adherence to treatment. Oneway to intervene is sending reminder cues using short messageservice (SMS) texts. We conducted a pilot study on the use ofSMS among pregnant and breastfeeding women living withHIV in Kilimanjaro, Tanzania. One objective was to investigatetechnical feasibility of sending SMS reminders.

Methods

We enrolled adult (age 18–45) pregnant or breastfeeding women living with HIV from Kilimanjaro region, Tanzania. Women received a reminder SMS 30 min before usual time of intake. One hour after usual time of intake, they received an SMS asking whether she took medication. The women had to reply with ‘Yes ’ or ‘No’. SMSes were sent less-than-daily and randomly distributed over the week.We did descriptive analyses of sent messages, delivered messages andestimation of adherence based on messages.

Results

We enrolled 25 women. In total, 4963 messages weresent of which 40 failed to be delivered (1%). 1664 SMS weresent with a question if medication was taken, wich receivedan answer 1580 times (91%). The answer was ‘Yes ’ in 1137cases (65%), ‘No’ in 10 cases (0.6%) and indefinable in 433cases (26%). The median adherence based on ‘Yes ’-answerswas 74% [range 24–99]. If also counting the indefinableanswers, the mean adherence was 100% [range 95–100].

 

Conclusion

Despite a few technical issues, we believe usingSMS for reminder cues in Tanzania works well. The numberof failed deliveries is nearly zero and women have replied tothe majority of SMS. Efforts are needed to instruct womenbetter on replying and on detecting the right answer in caseof typing errors. We conclude that using SMS has potential toimprove adherence and should be further investigated in clinicaltrials to determine the effect on adherence to treatment.