Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings.
Accurate measurement of adherence is necessary to ensure that therapeutic outcomes can be attributed to the recommended treatment. Phone-based unannounced pill counts were shown to be feasible and reliable measures of adherence in developed settings; and have been further used as part of medication...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5648117?pdf=render |
| _version_ | 1828483077836374016 |
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| author | Yael Hirsch-Moverman Camilla Burkot Suzue Saito Koen Frederix Blanche Pitt Zenebe Melaku Tsigereda Gadisa Andrea A Howard |
| author_facet | Yael Hirsch-Moverman Camilla Burkot Suzue Saito Koen Frederix Blanche Pitt Zenebe Melaku Tsigereda Gadisa Andrea A Howard |
| author_sort | Yael Hirsch-Moverman |
| collection | DOAJ |
| description | Accurate measurement of adherence is necessary to ensure that therapeutic outcomes can be attributed to the recommended treatment. Phone-based unannounced pill counts were shown to be feasible and reliable measures of adherence in developed settings; and have been further used as part of medication adherence interventions. However, it is not clear whether this method can be implemented successfully in resource-limited settings, where cellular network and mobile phone coverage may be low. Our objective is to describe operational issues surrounding the use of phone-based unannounced pill counts in Lesotho and Ethiopia.Phone-based monthly unannounced pill counts, using an adaptation of a standardized protocol from previous US-based studies, were utilized to measure anti-TB and antiretroviral medication adherence in two implementation science studies in resource-limited settings, START (Lesotho) and ENRICH (Ethiopia).In START, 19.6% of calls were completed, with 71.9% of participants reached at least once; majority of failed call attempts were due to phones not being available (54.8%) or because participants were away from the pills (32.7%). In ENRICH, 33.5% of calls were completed, with 86.7% of participants reached at least once; the main reasons for failed call attempts were phones being switched off (31.5%), participants not answering (27.3%), participants' discomfort speaking on the phone (15.4%), and network problems (13.2%). Structural, facility-level, participant-level, and data collection challenges were encountered in these settings.Phone-based unannounced pill counts were found to be challenging, and response rates suboptimal. While some of these challenges were specific to local contexts, most of them are generalizable to resource-limited settings. In a research study context, a possible solution to ease operational challenges may be to focus phone-based unannounced pill count efforts on a randomly selected sample from participants who are provided with study phones and rigorously ensure that call attempts are made for these participants. |
| first_indexed | 2024-12-11T08:29:29Z |
| format | Article |
| id | doaj.art-1ab99a7d1bf5460889095cc09ffbe9a5 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T08:29:29Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1ab99a7d1bf5460889095cc09ffbe9a52022-12-22T01:14:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011210e018554910.1371/journal.pone.0185549Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings.Yael Hirsch-MovermanCamilla BurkotSuzue SaitoKoen FrederixBlanche PittZenebe MelakuTsigereda GadisaAndrea A HowardAccurate measurement of adherence is necessary to ensure that therapeutic outcomes can be attributed to the recommended treatment. Phone-based unannounced pill counts were shown to be feasible and reliable measures of adherence in developed settings; and have been further used as part of medication adherence interventions. However, it is not clear whether this method can be implemented successfully in resource-limited settings, where cellular network and mobile phone coverage may be low. Our objective is to describe operational issues surrounding the use of phone-based unannounced pill counts in Lesotho and Ethiopia.Phone-based monthly unannounced pill counts, using an adaptation of a standardized protocol from previous US-based studies, were utilized to measure anti-TB and antiretroviral medication adherence in two implementation science studies in resource-limited settings, START (Lesotho) and ENRICH (Ethiopia).In START, 19.6% of calls were completed, with 71.9% of participants reached at least once; majority of failed call attempts were due to phones not being available (54.8%) or because participants were away from the pills (32.7%). In ENRICH, 33.5% of calls were completed, with 86.7% of participants reached at least once; the main reasons for failed call attempts were phones being switched off (31.5%), participants not answering (27.3%), participants' discomfort speaking on the phone (15.4%), and network problems (13.2%). Structural, facility-level, participant-level, and data collection challenges were encountered in these settings.Phone-based unannounced pill counts were found to be challenging, and response rates suboptimal. While some of these challenges were specific to local contexts, most of them are generalizable to resource-limited settings. In a research study context, a possible solution to ease operational challenges may be to focus phone-based unannounced pill count efforts on a randomly selected sample from participants who are provided with study phones and rigorously ensure that call attempts are made for these participants.http://europepmc.org/articles/PMC5648117?pdf=render |
| spellingShingle | Yael Hirsch-Moverman Camilla Burkot Suzue Saito Koen Frederix Blanche Pitt Zenebe Melaku Tsigereda Gadisa Andrea A Howard Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. PLoS ONE |
| title | Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. |
| title_full | Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. |
| title_fullStr | Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. |
| title_full_unstemmed | Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. |
| title_short | Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings. |
| title_sort | reaching the end of the line operational issues with implementing phone based unannounced pill counts in resource limited settings |
| url | http://europepmc.org/articles/PMC5648117?pdf=render |
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