Short Message Service (SMS) reminders improve patient on-time pill pick-up of their antiretroviral medicines in Namibia. Samson S.
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2 Short Message Service (SMS) reminders improve patient on-time pill pick-up of their antiretroviral medicines in Namibia Samson S. Mwinga
3 Background Methodology Results Conclusion Success story Acknowledgements Outline
4 Background Namibia profile 210,000 people living with HIV (PLHIV) i 13.3% prevalence rate in adults aged between 15 and 49 years old 84% (158,000) patients on ART as of Sep 2016 ii Sources: (i) UNAIDS Global Report, 2016 (ii) Quarterly ART Feedback Report (Jul Sep 2016), MoHSS, Namibia
5 Background... Ministry of Health and Social Services (MoHSS) data shows: lateness of pill pickup accounted for 30% (177/589) of patients interviewed while 67% (395/589) had missed their dose due to forgetfulness i Retention at 12 months for quarter Jul-Sep 2015 was 73.9% (adults) and 82.3% (pediatrics) ii Namibia boasts strong mobile network coverage with affordable voice call and text message services has recently introduced 4G in major cities Sources: (i) Namibia ART Adherence Baseline Survey Report, 2013 (ii) Quarterly ART Feedback Report (Jul Sep 2016), MoHSS, Namibia
6 Background... Data from the Electronic Dispensing Tool (EDT), implemented through the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) project, shows that patients miss their pharmacy appointments and patients exhibit sub-optimal adherence rates by pill count
7 Methodology SIAPS supported the MoHSS to implement the EDT-based pharmacy appointment and adherence reminder service at ten sites (in six of the Namibia s 14 regions) Sites were selected using cluster randomization based on their adherence scores in terms of two HIVDR early warning indicators (EWIs) EWI1 on-time pill pickup and EWI2 retention in care at 12 months pharmacy and clinical teams including counsellors were oriented on the recruitment process messages were translated into 7 local languages
8 Results By Oct 2016 Seven (7) ART sites had successfully implemented the appointment reminder service 40% (8,147/20,377) of patients had enrolled for the service
9 Results Between Oct Dec 2016 more than 9,000 text messages were sent out A strong correlation between patients picking up their ARVs on time and the density of SMS reminders was observed.
10 By Dec 2016, on-time pill pickup had improved from 73% in the previous quarter to 89.4% for patients enrolled for the SMS reminder service Results
11 Conclusion The SMS pharmacy appointment reminders improved on-time pill pickup for patients who had enrolled for the service. is recommended for roll out to all 51 main sites in Namibia and be integrated into the routine functioning of the ART program in Namibia MoHSS should partner with mobile network operators to optimize the scale up of the reminder service.
12 Success story Comments from some of the patients interviewed at one of the ART sites: Before the SMS, I would still honor my appointments because I always check in the health passport. Now it is even easier because of the SMS that comes directly to my cell phone, said. It is a good back-up system. I am happy to receive the SMS because it reminds me to go to the pharmacy to pick up my medicines, she said, adding that it is quite easy to forget an appointment, especially when she is busy.
13 Acknowledgements MoHSS Directorate of Special Programs MoHSS Directorate of Tertiary Health Care and Clinical Support Services MoHSS Division Pharmaceutical Services MoHSS - main ART / EDT sites MoHSS Adherence Technical Working Group and the TAC U.S. Agency for International Development
14 Abstract submission Key Terms: Short Message Services (SMS), Adherence, HIVDR Track: Antiretroviral Therapy Medication Adherence Themes: Intervention development, implementation, and/or outcomes Key Populations/Settings: Resource limited settings, Treatment experienced
15 Authors Ndapewa Hamunime, Ministry of Health and Social Services; Francina Kaindjee-Tjituka, Ministry of Health and Social Services; Salomo Natanael, Ministry of Health and Social Services; Samson Mwinga, MSH/SIAPS (Primary Presenter); Greatjoy Mazibuko, Management Sciences for Health/Systems for Improved Access to Pharmaceuticals and Services; Steven Hong, Tufts Medical Centre; Evans Sagwa, MSH/SIAPS; Harriet Kagoya, MSH/SIAPS; Dorothy Maloboka, Ministry of Health and Social Services; Rosalia Indongo, USAID Namibia; Bayobuya Phulu, MSH/SIAPS; David Mabirizi, MSH/SIAPS; Dinah Tjipura, MSH/SIAPS; Wuletaw Churfo, Ministry of Health and Social Services.
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