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Intro mHealth The practice of medicine and public health supported by mobile devices has emerged in recent years for developing countries as a means of.

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Presentation on theme: "Intro mHealth The practice of medicine and public health supported by mobile devices has emerged in recent years for developing countries as a means of."— Presentation transcript:

1 Intro mHealth The practice of medicine and public health supported by mobile devices has emerged in recent years for developing countries as a means of providing greater access to larger segments of a population and improving the capacity of health systems in such countries. Tool for HIV Adherence Promotion 2 recent RCT supporting mhealth & ART adherence: Lester RT et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010 Pop-Eleches C et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011;

2 Intro Weltel Kenya1 (Lancet 2010) Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya 538 patient randomised control trial (RCT) initiating ART 2 arms: 1. SMS intervention 2. Control/Standard of Care SMS intervention arm: 1 weekly SMS for 1 year Respond within 48 hours Patients responding problem & non-responders called back Results: SMS intervention group: significant improvements in adherence and viral suppression Viral Load Suppression: 57% intervention vs 48% control ART adherence (>95%): 62% intervention vs 50% Viral load suppression NNT = 11 ART adherence NNT= 9

3 Methods & Results Scale-up 1.Kenya – approx. 500, 000 ART patients 2.PEPFAR (global) – approx. 2.5 million ART patients Costs Activity Based Costing – SMS Intervention: $11.75 USD/year per patient – Kenya $10.21 USD/year per patient - PEPFAR Cost Savings

4 Methods & Results Kenya (n= 500,000)

5 Methods & Results PEPFAR (n=2.5 million)

6 Future Directions/Challenges - Scale up and Implementation Funding: 1.Patient 2.Health Systems/Programs (** major funder) 3.Industry Pharma Mobile Future Research Implementation Science– Step Wedge Study Thank You. www.weltel.org www.weltel.org Richard.Lester @ bccdc.ca bella@weltel.org

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