The Acceptability of Adherence Support via Mobile Phones for Antituberculosis Treatment in South India: Exploratory Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: India has the greatest burden of Tuberculosis (TB). But over 15% of the people on antitubercular therapy (ATT) in India are non-adherent. Several adherence monitoring techniques deployed in India to enhance ATT adherence have had modest effects. Increased adoption of mobile phones and other technologies pose potential solutions to measuring and intervening in ATT adherence. Several technology-based interventions around ATT adherence have been demonstrated in other countries. Objective: We sought to understand the formative acceptance of mobile phone adherence support among patients with TB on ATT. Methods: We used self-administered quantitative measures among 100 patients on ATT at the TB treatment Center (TTC) at a tertiary care center in Thrissur, Kerala, India. The participants were recruited using convenience sampling after obtaining written informed consent. Trained study staff administered the questionnaire in the local language of the participant. Results: Of the 100 participants diagnosed with TB on directly observed treatment short-course (DOTS), 90% used mobile phones routinely, and 84% owned a mobile phone. Ninety-five percent knew how to use the calling function, while 65% did not know how to use the SMS function on their mobile phone. Overall, 89% of the participants did not consider mobile phone-based ATT adherence interventions an intrusion in their privacy; 93% did not fear stigma if the adherence reminder was received by someone else. Most (95%) of the study participants preferred mobile phone reminders instead of DOTS. The most preferred reminder modality was voice calls (N=80, 80%) compared to SMS reminders (N=5, 5%). Conclusions: We found a high uptake of mobile phones among patients with TB in India. Preference of voice call reminders among the participants should be considered and strengthening the current adherence monitoring system is deemed appropriate. Future ATT adherence interventions should consider integrating mobile phone-based daily reminders.