title: A Qualitative Evaluation of the Acceptability of an Interactive Voice Response System to Enhance Adherence to Isoniazid Preventive Therapy Among People Living with HIV in Ethiopia.
abstract: Interactive voice response (IVR) is increasingly used to monitor and promote medication adherence. In 2014, we evaluated patient acceptability toward IVR as part of the ENRICH Study, aimed to enhance adherence to isoniazid preventive therapy for tuberculosis prevention among HIV-positive adults in Ethiopia. Qualitative interviews were completed with 30 participants exposed to 2867 IVR calls, of which 24 % were completely answered. Individualized IVR options, treatment education, and time and cost savings facilitated IVR utilization, whereas poor IVR instruction, network and power malfunctions, one-way communication with providers, and delayed clinic follow-up inhibited utilization. IVR acceptability was complicated by HIV confidentiality, mobile phone access and literacy, and patient-provider trust. Incomplete calls likely reminded patients to take medication but were less likely to capture adherence or side effect data. Simple, automated systems that deliver health messages and triage clinic visits appear to be acceptable in this resource-limited setting.
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA. ad2254@cumc.columbia.edu.|Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa. ad2254@cumc.columbia.edu.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. ad2254@cumc.columbia.edu.
authors.forename: Amrita
authors.initials: A
authors.lastname: Daftary
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
authors.forename: Yael
authors.initials: Y
authors.lastname: Hirsch-Moverman
authors.affiliation: School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Getnet M
authors.initials: GM
authors.lastname: Kassie
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA.
authors.forename: Zenebe
authors.initials: Z
authors.lastname: Melaku
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA.
authors.forename: Tsigereda
authors.initials: T
authors.lastname: Gadisa
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
authors.forename: Suzue
authors.initials: S
authors.lastname: Saito
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street, 13th Floor, New York, New York, 10032, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Howard
mesh_terms: D000328:Adult; D040421:Cell Phone; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000627:therapeutic use; D055118:Medication Adherence; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D017010:Reminder Systems; D017216:Telemedicine; D014376:Tuberculosis / Q000517:prevention & control*
chemical_list: D007538:Isoniazid
keywords: HIV/AIDS; Interactive voice response; Mobile health; Patient acceptability; Qualitative methods; Tuberculosis prevention