1365. Improving Appointment Adherence among Young Adults with HIV in Peru with an mHealth Intervention: a Feasibility Study
Session: Poster Abstract Session: HIV Care Continuum
Friday, October 6, 2017
Room: Poster Hall CD
Background: Mobile Health (mHealth) interventions, including short message services (SMS) reminders and motivational messages, are associated with improved HIV appointment adherence, though feasibility is context-dependent. We assessed the feasibility of an mHealth intervention to improve appointment adherence among young adults with HIV in Lima, Peru.

Methods: Between November 2016 - April 2017, we implemented a one-way mHealth pilot intervention in an outpatient hospital without electronic medical records. We enrolled young adults (age 18-29) entering HIV care in a 3-component intervention: (i) reminder SMS prior to scheduled appointments (provider, laboratory, pharmacy); (ii) motivational SMS after each visit; and (iii) phone call following a missed visit. Feasibility evaluation included enrollment acceptance, visit tracking (information captured in the study database within 3 days of attendance), and proportion of intervention delivery (threshold >90%). We performed a qualitative assessment to identify implementation challenges reviewing staff field notes and meeting minutes.

Results: We enrolled 80/94 (85.1%) eligible participants. The median age was 25 years and 83% were male. The median time of follow-up after enrollment was 115 [interquartile range (IQR): 84 - 141] days, and participants had a median of 10 (IQR: 8-14) visits during the study period. Among 850 total participant visits, study personnel tracked 751 (88.4%); most (80.8%) untracked visits were pharmacy pickups. Of all tracked visits, most (78.7%) were scheduled appointments and 160 (21.3%) were unscheduled walk-ins. Intervention delivery reached 556/591 (94.1%) for reminder SMS; 733/751 (97.6%) for motivational messages, and 169/170 (99.4%) phone calls for missed visits, 127 (75.1%) of which were answered. Qualitative assessment revealed 2 major themes: real-time appointment tracking in a paper-based system consumed most staff time and resources, and meticulous in-person coordination between the implementation and hospital staff was essential for tracking.

Conclusion: An mHealth intervention to improve appointment adherence among young adults with HIV in Peru appears feasible with dedicated staff and a reliable appointment tracking system. Digitalized appointment systems may be needed to address challenges for scale-up.

Mateo Prochazka, MD MSc1, D Scott Batey, PhD2, Anne Zinski, PhD3, Jodie Dionne-Odom, MD3, Larissa Otero, MD PhD1, J Martin Rodriguez, MD4 and Elsa González, MD1, (1)Instituto De Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, (2)Social Work, University of Alabama at Birmingham, Birmingham, AL, (3)1917 Clinic, University of Alabama at Birmingham, Birmingham, AL, (4)University of Alabama at Birmingham, Birmingham, AL


M. Prochazka, None

D. S. Batey, None

A. Zinski, None

J. Dionne-Odom, None

L. Otero, None

J. M. Rodriguez, None

E. González, None

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