TY - JOUR
T1 - “I Wish to Continue Receiving the Reminder Short Messaging Service”: A Mixed Methods Study on the Acceptability of Digital Adherence Tools Among Adults Living with HIV on Antiretroviral Treatment in Tanzania
AU - Ngowi, Kennedy
AU - Pima, Francis
AU - Mmbaga, Blandina Theophil
AU - Aarnoutse, Rob E.
AU - Reiss, Peter
AU - Nieuwkerk, Pythia T.
AU - Sprangers, Mirjam
AU - Boer, Marion Sumari-De
N1 - Funding Information: W e thank the participants for their involvement in our study and for allowing us to study potentially sensitive data. Furthermore, we thank the administration of the Kilimanjaro Christian Medical Centre and Majengo Dispensary for allowing us to conduct this study in the hospital and the nurse counselors for recruiting the participants. Also, we thank Janet Prvu Bettger , ScD, F AHA is an Associate Professor - health services researcher at Duke University and Jenny Renju Lecturer at London School of Hygiene & T ropical Medicine for providing technical expertise for writing scientific qualitative manuscript. Last, we thank the European and Developing Countries Clinical T rials Partnership (EDCTP) for the financial support to conduct the study . Publisher Copyright: © 2021 Ngowi et al.
PY - 2021
Y1 - 2021
N2 - Introduction: Digital Adherence Tools (DAT) to promote adherence to antiretroviral treatment (ART) for HIV are being increasingly adopted globally, however their effectiveness and acceptability in limited resource settings has been challenging. In this study, we examine the acceptability of DATs to improve adherence to ART. Methods: This study was part of a three-arm randomized controlled trial (REMIND) which investigated the effect of two different DAT’s: SMS text messages (SMS) or real-time medication monitoring (RTMM) on treatment adherence; compared to standard of care. Exit interviews and in-depth interviews were conducted at 48 weeks follow-up, to collect data on their experiences (successes, challenges, and barriers) and behaviours regarding the implementation of the interventions. Translated tran-scripts, memos and field notes were imported to NVivo software version 12. We used a thematic framework analysis which drew from Sekhon’s theoretical framework of acceptability (TFA), which comprises of seven constructs (affective attitude, perceived burden, perceived effectiveness, ethicality, self-efficacy, intervention coherence and opportunity costs). Results: Of the 166 participants enrolled, 143 (86%) were interviewed (68 in the SMS arm and 75 in the RTMM arm). Participants were highly satisfied (98%) with the DAT system and the majority of them reported it motivated them to take their medication (99%). The majority of participants reported they were confident in their ability to comply with the intervention and understood how the intervention worked (97%). Very few reported negatively about the devices (carrying the device), with only 6% reporting that they did not feel comfortable and 8% had ethical concerns with the SMS-content A few participants reported challenges with their connectivity/network and that the visits were too time-consuming. A few participants reported that they incurred extra cost for the sake of the study. Conclusion: Overall, the acceptability of these DATs was high. However, several factors may hamper their acceptability including the content and number of SMS, carrying the devices and the network availability.
AB - Introduction: Digital Adherence Tools (DAT) to promote adherence to antiretroviral treatment (ART) for HIV are being increasingly adopted globally, however their effectiveness and acceptability in limited resource settings has been challenging. In this study, we examine the acceptability of DATs to improve adherence to ART. Methods: This study was part of a three-arm randomized controlled trial (REMIND) which investigated the effect of two different DAT’s: SMS text messages (SMS) or real-time medication monitoring (RTMM) on treatment adherence; compared to standard of care. Exit interviews and in-depth interviews were conducted at 48 weeks follow-up, to collect data on their experiences (successes, challenges, and barriers) and behaviours regarding the implementation of the interventions. Translated tran-scripts, memos and field notes were imported to NVivo software version 12. We used a thematic framework analysis which drew from Sekhon’s theoretical framework of acceptability (TFA), which comprises of seven constructs (affective attitude, perceived burden, perceived effectiveness, ethicality, self-efficacy, intervention coherence and opportunity costs). Results: Of the 166 participants enrolled, 143 (86%) were interviewed (68 in the SMS arm and 75 in the RTMM arm). Participants were highly satisfied (98%) with the DAT system and the majority of them reported it motivated them to take their medication (99%). The majority of participants reported they were confident in their ability to comply with the intervention and understood how the intervention worked (97%). Very few reported negatively about the devices (carrying the device), with only 6% reporting that they did not feel comfortable and 8% had ethical concerns with the SMS-content A few participants reported challenges with their connectivity/network and that the visits were too time-consuming. A few participants reported that they incurred extra cost for the sake of the study. Conclusion: Overall, the acceptability of these DATs was high. However, several factors may hamper their acceptability including the content and number of SMS, carrying the devices and the network availability.
KW - ART
KW - Acceptability
KW - Adherence
KW - DAT
KW - Digital adherence tool
KW - Real-time medication monitoring
KW - SMS reminders
UR - http://www.scopus.com/inward/record.url?scp=85102979807&partnerID=8YFLogxK
U2 - https://doi.org/10.2147/PPA.S290079
DO - https://doi.org/10.2147/PPA.S290079
M3 - Article
C2 - 33727801
SN - 1177-889X
VL - 15
SP - 559
EP - 568
JO - Patient preference and adherence
JF - Patient preference and adherence
ER -