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WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTH INTERVENTION HIV/AIDS SUPPORT Richard.Lester @ bccdc.ca

Intro mHealth The practice of medicine and public health supported by mobile devices has emerged in recent years for developing countries as a means of providing greater access to larger segments of a population and improving the capacity of health systems in such countries.

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WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTH INTERVENTION HIV/AIDS SUPPORT Richard.Lester @ bccdc.ca

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  1. Intro mHealth The practice of medicine and public health supported by mobile devices has emerged in recent years for developing countries as a means of providing greater access to larger segments of a population and improving the capacity of health systems in such countries. WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org • Tool for HIV Adherence Promotion • 2 recent RCT supporting mhealth & ART adherence: • Lester RT et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010 • Pop-Eleches C et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011;

  2. Intro • Weltel Kenya1 (Lancet 2010) • Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya • 538 patient randomised control trial (RCT) initiating ART • 2 arms: 1. SMS intervention 2. Control/Standard of Care • SMS intervention arm: • 1 weekly SMS for 1 year • Respond within 48 hours • Patients responding problem & non-responders called back • Results: • SMS intervention group: significant improvements in adherence and viral suppression • Viral Load Suppression: 57% intervention vs 48% control • ART adherence (>95%): 62% intervention vs 50% WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org • Viral load suppression NNT = 11 • ART adherence • NNT= 9

  3. Methods & Results Scale-up Kenya – approx. 500, 000 ART patients PEPFAR (global) – approx. 2.5 million ART patients • Costs • Activity Based Costing – SMS Intervention: • $11.75 USD/year per patient – Kenya • $10.21 USD/year per patient - PEPFAR • Cost Savings WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org

  4. Methods & Results Kenya (n= 500,000) WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org

  5. Methods & Results PEPFAR (n=2.5 million) WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org

  6. Future Directions/Challenges - • Scale up and Implementation • Funding: • Patient • Health Systems/Programs (** major funder) • Industry • Pharma • Mobile • Future Research • Implementation Science– Step Wedge Study WELTEL KENYA: USING MOBILE PHONES AS A COST-EFFECTIVE HEALTHINTERVENTIONHIV/AIDS SUPPORTRichard.Lester@bccdc.ca bella@weltel.org • Thank You • . www.weltel.org • Richard.Lester@bccdc.ca bella@weltel.org

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