Cell phone, mobile phone, mhealth, adherence, compliance, health, medication, africa, sub sahara, zambia, malaria
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.
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Sole, Mary Lou
Doctor of Philosophy (Ph.D.)
College of Nursing
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Dissertations, Academic -- Nursing; Nursing -- Dissertations, Academic
Steury, Elinda, "Mobile Phone Short Message Service (SMS) to Improve Malaria Pharmacoadherence in Zambia" (2014). Electronic Theses and Dissertations. 4802.
Restricted to the UCF community until August 2015; it will then be open access.