Feasibility and cost of using mobile phones for capturing drug safety information in peri-urban settlement in Ghana: a prospective cohort study of patients with uncomplicated malaria

Abstract

BackgroundThe growing need to capture data on health and health events using faster and efficient means to enable prompt evidence-based decision-making is making the use of mobile phones for health an alternative means to capture anti-malarial drug safety data. This paper examined the feasibility and cost of using mobile phones vis-à-vis home visit to monitor adverse events (AEs) related to artemisinin-based combination therapy (ACT) for treatment of uncomplicated malaria in peri-urban Ghana.MethodsA prospective, observational, cohort study conducted on 4270 patients prescribed ACT in 21 health facilities. The patients were actively followed by telephone or home visit to document AEs associated with anti-malarial drugs. Call duration and travel distances of each visit were recorded. Pre-paid call cards and fuel for motorbike travels were used to determine cost of conducting both follow-ups. Ms-Excel 2010 and STATA 11.2 were used for analysis.ResultsOf the 4270 patients recruited, 4124 (96.6 %) were successfully followed up and analyzed. Of these, 1126/4124 (27.3 %) were children under 5 years. Most 3790/4124 (91.9 %) follow-ups were done within 7 days of ACT intake. Overall, follow up by phone (2671/4124—64.8 %) was almost two times the number done by home visits (1453/4124—35.2 %). Duration of telephone calls ranged from 38 s to 53 min, costing between GH¢0.26 (0.20USD) and GH¢41.70 (27.USD). On the average, the calls lasted 3 min 51 s (SD = 3 min, 21 s) costing GH¢2.70 (0.77USD). Distance travelled for home visit ranged from 0.65 to 62 km costing GH¢0.29 (0.20USD) and GH¢279.00 (79.70USD). Thirty-two per cent (1128/4124) of patients reported AEs. In total, 1831 AE were reported, 1016/1831(55.5 %) by telephone and 815/1831 (44.5 %) by home visits. Events such as nausea, dizziness, diarrhoea, and vomiting were commonly reported.ConclusionMajority of patients was successfully followed up by telephone and reported the most AEs. The cost of telephone interviewing was almost two times less than the cost of home visit. Telephone follow up should be considered for monitoring drug adverse events in low resource settings.

Evaluation of Two Strategies for Community-Based Safety Monitoring during Seasonal Malaria Chemoprevention Campaigns in Senegal, Compared with the National Spontaneous Reporting System

“…For reports submitted by mobile phone, the average delay from case presentation to the notification reaching the central office was 24 h. In a study using SMS to monitor AEs after immunization in Australia, most patients who received an SMS query about adverse vaccine reactions sent a response within 2 h of receiving the query [ 16 ]. A study in Ghana, where the use of mobile phones to contact patients was compared with home visits to identify AEs related to artemisinin-based combination therapy for treating uncomplicated malaria found a slightly higher reporting rate with mobile phones, and that it was possible to interview the majority of patients within a few days [ 17 ]. In Uganda, an SMS-based reporting system for monitoring malaria diagnosis and treatment improved timeliness in data reporting [ 18 ].…”

Safety of a fixed-dose combination of artesunate and amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in real-life conditions of use in Côte d’Ivoire

“…The study that is perhaps the closest to the present one in design is the INDEPTH study of a fixed-dose combination of dihydroartemisinin and piperaquine phosphate (Eurartesim ® ), conducted in four African countries between 2013 and 2014 [21], which included 11,097 patients with RDT-confirmed P. falciparum infections who were followed up by home visits from a CHW or by telephone. More recently, a study in Ghana of patients prescribed ACT [27] has compared telephone contact and home visits by a CHW and found that the former method elicited more AEs and was less expensive to implement. On the other hand, a Nigerian study with telephone monitoring which enrolled patients buying anti-malarials in a pharmacy reported that, for many patients, telephone contact was not maintained over time [28].…”

<p>Optimal Approach and Strategies to Strengthen Pharmacovigilance in Sub-Saharan Africa: A Cohort Study of Patients Treated with First-Line Artemisinin-Based Combination Therapies in the Nanoro Health and Demographic Surveillance System, Burkina Faso</p>

“…In addition, the introduction of newer technologies such as cell phones to report and investigate AEs to any medical products or certain specific therapeutic classes could provide added value. 44,[51][52][53] The latter could facilitate rapid identification of drug safety signals, provided that connectivity conditions are good.…”