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SMS Text confirmation system for HIV patients daily medication at Princess Marina IDCC clinic, Botswana

Author: Jason Wucinski of Peace Corps Volunteer Botswana.

1. Background

This project is designed to create a comprehensive support system for HIV positive patients using SMS technology. The project also focuses on increasing communication between doctors and patients because this is an issue identified by both doctors and patients as being one in which assistance was needed.

Our concept is relatively simple, a server sends out text messages to patients to remind them to take their individual daily pills, refill their prescriptions and attend their doctor appointments. Patients respond to the individual pill reminders to either confirm that they have taken their medication or if they were unable to then they identify the reason they did not. Patients who respond to their texts 95% or more of the time will be awarded a small prize every month such as airtime, phones, gift vouchers and other incentives.

We are planning to pilot the service out of the Princess Marina IDCC clinic with a cohort of 500 patients that have already failed first line therapy and been identified as having issues with adherence. We wish to run the pilot for about 6 months starting in mid-February and we will use this to prove that patients actually benefit from this type of service. During this phase we will be scaling up and improving the system and we plan to increase the availability of our system and increase the total number of patients enrolled.

2. Problem Statement

ARV treatment only works if patients take their medications correctly and on time 100% of the time. Many factors contribute to patients not taking their medication when prescribed, including adverse side effects, forgetfulness, inconvenience, lack of knowledge, etc. This project aims to correct these interferences in the following ways:

  • Users will be able to subscribe to our service (free of charge) to receive reminders every day at the time the meds should be taken (even taking medications 20 out of sync with daily routine can cause problems such as resistance)
  • Although we cant alleviate undesirable side effects from the medication we hope to offer some form of incentive by offering rewards (at first free air time, phones, etc but to make it more sustainable we will move towards ringtone, wallpapers, games, etc that could be downloaded to their phones
  • Sometimes all that is needed is just a friendly reminder. So, patients will also be able to get their reminders in different forms (such as jokes, horoscopes, poems, etc. This helps to protect a patient's confidentiality)
  • We are also looking at creating an educational feature. By sending and SMS with a key word (such as HIV facts) they will get a response with a list they can pick from, which will then send another SMS with said facts

3. Goals of the new System

Goals of the new system:

  • SMS must become the primary notification message type. Patients must get their reminders every day, on time.
  • Patients must be able to update their info via SMS
  • We must be able to send out high volume SMS. Starting pilot would be 500 a day
  • All notifications must be logged
  • We must have the option to create redirect SMS's for various reasons (such as patients asking questions, receiving incentive gifts, updating records, etc)

4. ActiveXperts SMS Messaging Server Solution

As a software designer I have volunteered to create the SMS interface for this project. The application will be written in Visual Basic 6. ActiveXperts SMS Messaging Server is responsible for the delivery of the messages. We will store all sent and received message in an MySQL database.

  • New outgoing SMS are stored in the Message Database of ActiveXperts SMS Messaging Server. ActiveXperts SMS Messaging Server is responsible for delivering these messages to the students;
  • The program uses the ActiveXperts Axsms-messaging-server.Messages object to access the Message Database of the SMS Messaging Server;
  • The ActiveXperts SMS Messaging Server service will notice any new messages in the Message Database and will send them out immediately;
  • Triggers will be used for various features, including HIV awareness help line, updating client records, and incentive features.

In closing, I would like to thank ActiveXperts for donating a license to our project. The money we will save will be redirected to other useful purposes (such as buying a computer). Your companies desire to help us gives us all hope for a successful project that will hopefully help hundreds, if not thousands, of peoples suffering from AIDS.