Keywords

Cell phone, mobile phone, mhealth, adherence, compliance, health, medication, africa, sub sahara, zambia, malaria

Abstract

Malaria significantly contributes to morbidity and mortality rates in Zambia. The currently accepted malaria treatment is artemisinin-based combination therapy (ACT); it is more than 97% effective when the regimen is strictly adhered to. However, the mean ACT adherence rate in sub-Saharan Africa is only approximately 38-48%. Poor pharmacoadherence remains a significant barrier to malaria control and elimination. The purpose of this study was to determine if adherence rates to a six-dose ACT antimalarial treatment differ between patients in Zambia who received short message service (SMS) reminders and those who did not. An experimental, randomized, controlled trial was conducted to collect data from a sample of 96 adult patients with malaria who presented to Fisenge Clinic in the Copperbelt Province of Zambia. Participants were randomly assigned to a control or intervention group. The intervention group received SMS messages to remind them to take their medication according to the regimen. An electronic pillbox was used to measure pharmacoadherence for both groups, and patients were classified as probably adherent or probably non-adherent. Data were analyzed using Chi-square for association between the SMS intervention and pharmacoadherence, and logistic regression used for predictors of adherence. No significant association was found between SMS reminders and pharmacoadherence among malaria patients being treated with ACT when evaluated with respect to those who received the SMS reminders and those who did not (x2=0.19, df=1, p=0.67). Binary logistic regression indicated that there were no variables associated with adherence (p > 0.05). Findings from this study contribute to the research regarding the use of mobile phones to promote adherence. This is the first study of its kind using SMS directly to the patient for ACT adherence in sub-Saharan Africa known to the author. It is possible that the use of the electronic pillbox and/or the novelty of participating in a research study contributed to higher levels of adherence than previously found in this geographical area. While data suggested that there was no association between SMS and adherence, further research is needed to explore the value of this intervention.

Notes

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Graduation Date

2014

Semester

Summer

Advisor

Sole, Mary Lou

Degree

Doctor of Philosophy (Ph.D.)

College

College of Nursing

Department

Nursing

Degree Program

Nursing

Format

application/pdf

Identifier

CFE0005421

URL

http://purl.fcla.edu/fcla/etd/CFE0005421

Language

English

Release Date

August 2015

Length of Campus-only Access

None

Access Status

Doctoral Dissertation (Open Access)

Subjects

Dissertations, Academic -- Nursing; Nursing -- Dissertations, Academic

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Included in

Nursing Commons

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