M-health improves health outcomes, especially in developing countries, Thirumurthy says
|May 24, 2012|
An article in the May issue of the Bulletin of the World Health Organization suggests that use of text messaging and other mobile phone applications may be an increasingly effective and cost-efficient means of improving health outcomes, especially in developing countries.
Harsha Thirumurthy, PhD, assistant professor of health policy and management at UNC Gillings School of Global Public Health, co-authored “M-health for health behavior change in resource-limited settings: applications to HIV care and beyond,” a perspective article that summarizes findings from recent studies of m-health interventions in low-income settings, including one Thirumurthy conducted in Kenya to improve adherence to HIV treatment.
“M-health” is shorthand for mobile, or electronic, health, a means of improving people’s health through messages sent via mobile phones or the Internet.
Thirumurthy notes that in 2011, 79 percent of people in developing countries had cellular phone subscriptions, compared to 26 percent with Internet access. This makes the mobile phone a particularly available potential tool for improving health.
He reported on two m-health interventions in Kenya that showed text messages can improve adherence to antiretroviral therapy (ART), thereby prolonging suppression of HIV. One study featured a weekly message that asked about patients’ health and recommended they seek advice from their health-care providers. These patients adhered better to their treatment than those in a control group who did not receive any messages.
In a second study, patients with HIV received one-way communications, either weekly or daily, that reminded them to take their medication. Those who received the weekly message adhered better to the ART than those who were reminded daily. The findings suggested that compliance was influenced more by supportive text in the messages than by simple daily reminders.
“These studies, which show that text messages can improve treatment adherence, suggest that such messages can be applied to evoke any behaviour that is amenable to the influence of encouragement and periodic reminders,” Thirumurthy wrote.
He says that the messages could be used to increase adherence to treatment regimens for malaria, tuberculosis and noncommunicable diseases, for the uptake of preventive interventions such as childhood vaccinations, and to prevent mother-to-child transmission of HIV.
“M-health interventions could be applied to a very broad range of health-related behaviours,” he said. “However, what works in one context does not necessarily work in another. Rigorous evaluations of small- and large-scale interventions could reveal the extent to which m-health can provide cost-effective solutions to public health challenges.”
Thirumurthy is planning future work in this area, starting with an evaluation of a phone-based intervention to improve maternal and child health outcomes in Uganda.
Richard Lester, MD, clinical assistant professor in the University of British Columbia’s Department of Medicine, co-authored the Bulletin article.