JMIR Publications

ABSTRACT

Background:

With the availability of low-cost mobile devices and ease of internet access, mobile health (mHealth) is digitally revolutionizing the health sector, even in resource constrained settings. It is however necessary, to assess end user perceptions before deploying potential interventions. This study was designed to explore the mobile phone usage patterns and the acceptability of mobile phone support during care and treatment in patients with tuberculosis (TB) in South India.

Methods:

This exploratory study was conducted at an urban private tertiary care teaching hospital and nearby public primary level healthcare facilities in Bangalore, South India. We recruited 185 patients with TB through consecutive sampling. Subsequent to written informed consent, participants responded to an interviewer administered pretested questionnaire. The questionnaire comprised demographics, phone usage patterns, and the benefit of using of mobile phone technology to improve health outcomes and treatment adherence. Frequency, mean, median and standard deviation or interquartile range were used to describe the data. Bivariate associations were assessed between demographics, clinical details, phone usage and mobile health communication preferences using the Chi square test and Odds ratios. Associations with a P value ≤.20 were included in a logistic regression model. A P value of <.05 was considered significant.

Results:

Of the 185 participants, 151 (82%) used a mobile phone, with half of them owning a smartphone. The primary use of the mobile phone was to communicate over voice calls (147, 97%). The SMS feature was used by only 66 (44%) of the mobile phone users. Of the mobile phone users, 87 (58%) knew how to use the camera. Only 41 (27%) of the mobile phone users had used their mobile phone to communicate with their health care provider. Though receiving medication reminders via mobile phones was acceptable to all participants, two participants considered repeated reminders as an intrusion of their privacy. A majority of the participants (137, 74%) preferred health communications via voice calls. Of the participants, 123 (67%) requested reminders to be sent only at specific times during the day, 22 (12%) suggested reminders should synchronize with their prescribed medication schedule, while 40 (22%) did not have any time preferences. English literacy was associated with a preference for SMS in comparison with voice calls. Most participants (142, 77%) preferred video based direct observed treatment (vDOT) when compared with in-person direct observed treatment (DOT). Conclusion: While mobile phones for supporting health and treatment adherence were acceptable to patients with TB, mHealth interventions should consider language, mode of communication and preferred timing for communication to improve uptake.