WELTEL KENYA: USING MOBILE mHealth PHONES AS A ... - INRUD
WELTEL KENYA: USING MOBILE mHealth PHONES AS A ... - INRUD
WELTEL KENYA: USING MOBILE mHealth PHONES AS A ... - INRUD
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Intro<br />
<strong>mHealth</strong><br />
The practice of medicine and public health supported by mobile<br />
devices has emerged in recent years for developing countries as a<br />
means of providing greater access to larger segments of a population<br />
and improving the capacity of health systems in such countries.<br />
• Tool for HIV Adherence<br />
Promotion<br />
• 2 recent RCT<br />
supporting mhealth &<br />
ART adherence:<br />
• Lester RT et al. Effects of a mobile phone short message<br />
service on antiretroviral treatment adherence in Kenya (WelTel<br />
Kenya1): a randomised trial. Lancet 2010<br />
• Pop‐Eleches C et al. Mobile phone technologies improve<br />
adherence to antiretroviral treatment in a resource‐limited<br />
setting: a randomized controlled trial of text message<br />
reminders. AIDS 2011;<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
COST‐EFFECTIVE<br />
HEALTH<br />
INTERVENTION<br />
HIV/AIDS<br />
SUPPORT<br />
Richard.Lester@bccdc.ca<br />
bella@weltel.org
Intro<br />
Weltel Kenya1 (Lancet 2010)<br />
Effects of a mobile phone short message service on antiretroviral<br />
treatment adherence in Kenya<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
COST‐EFFECTIVE<br />
HEALTH<br />
INTERVENTION<br />
•<br />
•<br />
538 patient randomised control trial (RCT) initiating ART<br />
2 arms: 1. SMS intervention ti 2. Control/Standard d of Care<br />
• SMS intervention arm:<br />
• 1 weekly SMS for 1 year<br />
• Respond within 48 hours<br />
• Patients responding problem & non‐responders called back<br />
• Results:<br />
HIV/AIDS<br />
• SMS intervention group: significant improvements in<br />
SUPPORT<br />
adherence and viral suppression<br />
• Viral Load Suppression: 57% intervention vs 48% control<br />
• ART adherence (>95%): 62% intervention vs 50%<br />
Richard.Lester@bccdc.ca<br />
• Viral load suppression<br />
bella@weltel.org<br />
NNT = 11<br />
• ART adherence<br />
NNT= 9
Methods & Results<br />
Scale‐up<br />
Costs<br />
1. Kenya – approx. 500, 000 ART patients<br />
2. PEPFAR (global) – approx. 2.5 million ART patients<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
COST‐EFFECTIVE<br />
HEALTH<br />
INTERVENTION<br />
Activity Based Costing –SMS Intervention:<br />
•$11.75 USD/year per patient –Kenya<br />
•$10.21 USD/year per patient ‐ PEPFAR<br />
HIV/AIDS<br />
SUPPORT<br />
Richard.Lester@bccdc.ca<br />
bella@weltel.org<br />
Cost Savings
Methods & Results<br />
Kenya (n= 500,000)<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
COST‐EFFECTIVE<br />
HEALTH<br />
INTERVENTION<br />
HIV/AIDS<br />
SUPPORT<br />
Richard.Lester@bccdc.ca<br />
bella@weltel.org
Methods & Results<br />
PEPFAR (n=2.5 million)<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
COST‐EFFECTIVE<br />
HEALTH<br />
INTERVENTION<br />
HIV/AIDS<br />
SUPPORT<br />
Richard.Lester@bccdc.ca<br />
bella@weltel.org
Future Directions/Challenges ‐<br />
<strong>WELTEL</strong> <strong>KENYA</strong>:<br />
• Scale up and Implementation<br />
<strong>USING</strong> <strong>MOBILE</strong><br />
• Funding:<br />
<strong>PHONES</strong> <strong>AS</strong> A<br />
1. Patient<br />
2. Health Systems/Programs (** major funder)<br />
COST‐EFFECTIVE<br />
3. Industry<br />
HEALTH<br />
INTERVENTION<br />
• Pharma<br />
• Mobile<br />
• Future Research<br />
• Implementation Science– Step Wedge Study<br />
Thank You<br />
. www.weltel.orgweltel Richard.Lester@bccdc.ca<br />
bella@weltel.org<br />
HIV/AIDS<br />
SUPPORT<br />
Richard.Lester@bccdc.ca<br />
bella@weltel.org
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