Browsing by Author "Bogg, Lennart"
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- ItemDesign of a randomized trial to evaluate the influence of mobile phone reminders on adherence to first line antiretroviral treatment in South India--the HIVIND study protocol.(2010-04-23) De Costa, Ayesha; Shet, Anita; Kumarasamy, Nagalingeswaran; Ashorn, Per; Eriksson, Bo; Bogg, Lennart; Diwan, Vinod K; ,BACKGROUND Poor adherence to antiretroviral treatment has been a public health challenge associated with the treatment of HIV Although different adherence supporting interventions have been reported their long term feasibility in low income settings remains uncertain Thus there is a need to explore sustainable contextual adherence aids in such settings and to test these using rigorous scientific designs The current ubiquity of mobile phones in many resource constrained settings make it a contextually appropriate and relatively low cost means of supporting adherence In India mobile phones have wide usage and acceptability and are potentially feasible tools for enhancing adherence to medications This paper presents the study protocol for a trial to evaluate the influence of mobile phone reminders on adherence to first line antiretroviral treatment in South India METHODS DESIGN 600 treatment na ve patients eligible for first line treatment as per the national antiretroviral treatment guidelines will be recruited into the trial at two clinics in South India Patients will be randomized into control and intervention arms The control arm will receive the standard of care the intervention arm will receive the standard of care plus mobile phone reminders Each reminder will take the form of an automated call and a picture message Reminders will be delivered once a week at a time chosen by the patient Patients will be followed up for 24 months or till the primary outcome i e virological failure is reached whichever is earlier Self reported adherence is a secondary outcome Analysis is by intention to treat A cost effectiveness study of the intervention will also be carried out DISCUSSION Stepping up telecommunications technology in resource limited healthcare settings is a priority of the World Health Organization The trial will evaluate if the use of mobile phone reminders can influence adherence to first line antiretrovirals in an Indian context
- ItemMobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?(2014-09-04) Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, AyeshaINTRODUCTION Adherence to antiretroviral treatment ART is critical to maintaining health and good clinical outcomes in people living with HIV AIDS To address poor treatment adherence low cost interventions using mobile communication technology are being studied While there are some studies that show an effect of mobile phone reminders on adherence to ART none has reported on the costs of such reminders for national AIDS programmes This paper aims to study the costs of mobile phone reminder strategies mHealth interventions to support adherence in the context of India s National AIDS Control Program NACP METHODS The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state South India Costs for a mobile phone reminder application to support adherence implemented at these sites i e weekly calls messages or both were studied Costs were collected based on the concept of avoidable costs specific to the application The costs that were assessed were one time costs and recurrent costs that included fixed and variable costs A sequential procedure for costing was used Costs were calculated at national programme level individual ART centre level and individual patient level from the NACP s perspective The assessed costs were pooled to obtain an annual cost per patient The type of application number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs RESULTS The Indian NACP would incur a cost of between 79 and 110 INR USD 1 27 1 77 per patient per year based on the type of reminder the number of patients on ART and the number of functioning ART centres The total programme costs for a scale up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0 36 of the total five year national programme budget CONCLUSIONS The cost of the mHealth intervention for ART adherence support in the context of the Indian NACP is low and is facilitated by the low cost of mobile communication in the country Extending the use of mobile communication applications beyond adherence support under the national programme could be done relatively inexpensively