Impact of an SMS reminder service on outpatient clinic attendance rates by patients with HIV followed-up at Pointe-à-Pitre University Hospital

Understanding no-show behaviour for cervical cancer screening appointments among hard-to-reach women in Bogotá, Colombia: A mixed-methods approach

The global burden of cervical cancer remains a concern and higher early mortality rates are associated with poverty and limited health education. However, screening programs continue to face implementation challenges, especially in developing country contexts. In this study, we use a mixed-methods approach to understand the reasons for no-show behaviour for cervical cancer screening appointments among hard-to-reach low-income women in Bogotá, Colombia. In the quantitative phase, individual attendance probabilities are predicted using administrative records from an outreach program (N = 23384) using both LASSO regression and Random Forest methods. In the qualitative phase, semi-structured interviews are analysed to understand patient perspectives (N = 60). Both inductive and deductive coding are used to identify first-order categories and content analysis is facilitated using the Framework method. Quantitative analysis shows that younger patients and those living in zones of poverty are more likely to miss their appointments. Likewise, appointments scheduled on Saturdays, during the school vacation periods or with lead times longer than 10 days have higher no-show risk. Qualitative data shows that patients find it hard to navigate the service delivery process, face barriers accessing the health system and hold negative beliefs about cervical cytology.

[Acceptability of the use of mobile phones for HIV management in Togo]

OBJECTIVE

To describe the acceptability and factors associated with the use of mobile telephones in the care of people living with HIV (PLHIV) in Lomé, Togo.

METHOD

A cross-sectional study was conducted from January 5th to March 31st, 2018 in Lomé. PLHIV were recruited from the Department of Infectious and Tropical Diseases of the teaching hospital “CHU Sylvanus Olympio” and the NGO “Espoir Vie Togo”. Socio-demographic and clinical data, mobile phone possession and acceptability of communication with health professionals using a mobile phone were collected with a standardized questionnaire during a face-to-face interview.

RESULTS

A total of 259 PLHIV (79.6% women) were recruited. The mean age (± standard deviation) of PLHIV was 43.7 ± 9.8 years and the majority (95.4%) had a mobile phone. Almost all (98.1%) of respondents declared that mobile phone could be a means to maintain contact with a health professional. Phone calls (43.0%), text messages (SMS) (35.1%), and voice messages (20.0%) were the preferred means of communication with health professionals. Factors associated with the acceptability of receiving SMS from a health professional were age < 44 years and having at least a secondary level of education.

CONCLUSION

PLHIV are receptive to the integration of mobile technology into the management of their condition. M-health could be an opportunity to improve the management of HIV infection in Togo.

Implementation of a Text Message to Improve Adherence to Clinic and Social Service Appointments

Introduction:

Attendance to clinic appointments and compliance with treatment plans are essential components of HIV/AIDS care. Compliance is especially important in young and minority individuals living with HIV/AIDS. We assessed the effectiveness of a text-based reminder system compared with usual care in improving the attendance to clinic and social work appointments at a Ryan White-funded clinic based in an academic institution.

Methods:

Convenience sample looking at 2 periods, 6 months before initiation of text messages and 6 months after initiation of text messages.

Results:

Following a 6-month postintervention period, we found a statistically significant reduction in our no-show rates (individuals failing to keep scheduled appointments) of 24.8% versus 17.7%, P value .05.

Conclusion:

Using an inexpensive online text messaging system, we were able to significantly decrease no-show rates in a primarily younger, low-income, and uninsured population.

The Effect of a Reminder Short Message Service on the Uptake of Glaucoma Screening by First-Degree Relatives of Glaucoma Patients: A Randomized Controlled Trial

PURPOSE

The purpose of this study was to determine the role of a reminder short message service (SMS) on the uptake of glaucoma screening by first-degree relatives (FDRs) of patients with primary open-angle glaucoma (POAG) in North-central Nigeria following a telephone invitation for screening.

MATERIALS AND METHODS

A randomized controlled trial was conducted in the eye clinic of a tertiary hospital in Jos, North-central Nigeria. Two hundred FDRs of patients with POAG were invited through phone for free glaucoma screening and randomly allocated into two groups. The intervention group received a reminder SMS, whereas the control group did not receive a reminder. Those who failed to turn up for screening were contacted through phone to determine the reasons for their nonattendance. Chi-square test and bivariate analysis were used to compare attendance rate between the two groups.

RESULTS

Sending a reminder SMS following a telephone invitation had no effect on the uptake of glaucoma screening. The response rate was lower in the phone call plus reminder SMS group (43.0% vs. 53.0%) though the difference was not statistically significant (P = 0.157). Competing needs such as work and lack of transport fare were the most common reasons given for not attending the screening.

CONCLUSION

A reminder text message is not an effective tool for increasing the uptake of glaucoma screening in at-risk individuals in North-central Nigeria. Existing barriers to health care in the country need to be addressed before mobile phone technology can be effectively used in increasing the utilization of any free eye screening service.