Integrated mobile phone interventions for adherence to antiretroviral treatment in clients with HIV infection in Accra, Ghana

Abstract

Mobile phone interventions such as text messaging have been used to improve treatment adherence globally and in sub-Saharan Africa. Nevertheless, integrated mobile phone intervention for adherence support in Ghana, has not been greatly extensively explored. An explanatory integrated mixed method research approach was employed within the context of a pragmatic paradigm to conduct a study in three phases. In phase one; a randomised control trial was done to determine the effect of mobile phone intervention on adherence in a two groups (Intervention and Control). Respondents (n = 362) age 18-60 years, HIV seropositive, with access to mobile phone were recruited and followed-up for six months. The Control group received standard care while the Intervention group received standard care, alarm prompting, weekly text messages and monthly voice calls. The implementation of interventions was based on King's transactional model of goal attainment while the logic model was used for intervention evaluation. Primary (overall adherence: Self-report, visual analogue, pill identification, pill count) and secondary (CD4 count and Body Mass Index) outcomes were measured at baseline, month three and month six. In phase two, individual interviews were conducted with six clients and two health professionals; three focus group discussions were held with participants from the Intervention group at month six.