Design, development, and testing of a voice-text mobile health application to support Tuberculosis medication adherence in Uganda

Abstract

Background Tuberculosis (TB) continues to persist with a high disease burden globally. Non-adherence to treatment remains a major problem to TB control. In Uganda, one in every four TB patients does not adhere to their TB medication. The purpose of this study was to design, develop and assess implementation of a voice-text-based mobile application to support TB patients’ adherence to medication. Methods Design science research methodology (DSRM) was utilized to develop a voice-text-based mobile health application. Agile software methodology was used to achieve steps of DSRM that are; design and development. Focus group discussions (FGDs) and Key informant interviews (KIIs) were conducted and data analysed using thematic content analysis. Results During problem identification, Stigma, transport costs, being asymptomatic, drug side effects, lack of family support were identified as challenges affecting adherence. Technologies identified and used for the development of the voice-text application included; extensible mark-up language (XML) File, Apache server, Ubuntu Server, Hypertext Pre-processor, and jQuery. In the pilot study, 27 voice messages were broadcasted, 85.2% were delivered, 103 text messages were sent and 92.2% were delivered to the intended recipients. Conclusions Voice-text message mobile health application can be used to reach a wider patient population and it has the capability of addressing some of the challenges affecting TB medication adherence.

Implementation outcomes of tuberculosis digital adherence technologies: a scoping review using the RE-AIM framework

“…Problems with implementing SMS-based interventions were reported by five authors [65][66][67][68][69]. Issues reported by people with TB included the inability to charge the phone battery, damaged phones, and no longer being able to access a shared phone.…”

The Usability and Impact of Mobile Health Applications on Tuberculosis treatment regimen: A Systematic Review

“…All of the included studies were RCTs that were published between 2018 and 2023. The research was carried out in the Uganda (Musiimenta et al, 2020;Ggita et al, 2019;Patel et al, 2020;Katende et al, 2022 ), India (Jose et al, 2022;Kumar et al, 2019;Thomas, Vignesh Kumar, et al, 2020;Selvaraju et al, 2022 ), South Africa (Moriarty et al, 2019), Ghana (Osei et al, 2021), Thailand (Ratchakit-Nedsuwan et al, 2020Kumwichar et al, 2022), Armenia (Khachadourian et al, 2020), and Australia (Sahile et al, 2021). A total of 2,408 TB patients and health workers, the mean age ranging from 18-50 as seen in the Table 2.…”

Collaborative desing in web aplication development to improve tuberculosis diagnostic

“…Some of these web-bases technology are related to: diagnosis of tuberculosis, tele-radiology, laboratory information management systems, electronic patient records, patient tracking systems [5]. This web-bases technology are applied in different areas to solve many importan problem like control the non-adherence to treatment and analyze the multi-drug resistance using technologies pillboxes and video directly observed therapy [6]. In that context web applications has a great support for the health sector, correctly oriented and can be used to solve any Public Health problem.…”