Abstract
Introduction
In Sub-Saharan Africa, there are knowledge gaps on adverse drug reactions (ADRs) of antiretroviral treatment. This study examined the acceptability and feasibility of short message service (SMS) to increase awareness about the importance of reporting ADRs among people living with HIV (PLHIV) in Tanzania.
Methods
In this pilot study, PLHIV consented to participate and received SMS asking about their health. Responses to messages generated a flow of follow-up questions through SMS that determined the presence of ADRs. Technical feasibility was calculated based on the percentage of SMS sent and delivered, and acceptability was based on SMS replies. We conducted focus group discussions and in-depth interviews with participants and healthcare workers to understand experiences and acceptability of the system. Qualitative data were analyzed using thematic content analysis, and quantitative data were summarized using descriptive analyses.
Results
Ninety-two participants were recruited. Sixty-two (67.4%) were women. The mean age was 42 years (SD ± 12). Among the sent SMS, 100 (95.2%) were replied to. Themes identified through qualitative data were: high motivation to report ADR, well-understood SMS content, no concerns about unwanted disclosure, and network difficulties.
Conclusion
The SMS system is a user-friendly intervention and highly accepted based on qualitative data among PLHIV in Tanzania.
Introduction
Human immunodeficiency virus (HIV) still causes high morbidity and mortality. Globally, it is estimated that 37.7 million people are living with HIV, and 84% reside in Sub-Saharan Africa. 1 In 2020, 27.7 million people were on antiretroviral treatment (ART). In Tanzania, 52% of people living with HIV (PLHIV) aged 15-65 know their status, and 91% of them are on ART. 2 ART must be taken every day since it does not provide a cure for the disease, as it only suppresses viral growth. 3 Despite the good outcomes, ART causes adverse drug reactions (ADRs), which are a burden to both the health system and the individual and may compromise the effectiveness of the ART programs. 4 ADR is defined as any response to medication that is noxious and unintended that may occur at normal doses. 5
ADRs may range from mild to acute or even life-threatening. These reactions are individualized, and they may not appear to everyone on certain medications due to different factors such as genetic differences.4,6 In addition, many PLHIV are tuberculosis (TB) co-infected or have other co-morbidities such as diabetes and cardiovascular conditions; hence, they are exposed to both ART and anti-TB drugs or other drugs, which may cause the risk of hepatotoxicity and renal damage to be higher.7,8 Furthermore, recent studies have described the burden of ART resistance related to ADR. A study in Tanzania reported that the rate of ADR among people on ART has caused more people not to adhere to their medication; hence, it causes higher rates of resistance to their treatment. 9 Data on ADR could inform policy guidelines on the best regimens for ART, and these data should come from national pharmacovigilance (PV) systems.10–12
Currently, the passive way of collecting data through national PV systems is not adequate. 12 In Tanzania, all reactions, whether predictable or unpredictable, serious or mild, and known or unknown, are reported as suspected ADRs and adverse events using special forms. However, according to Tanzania Medicine and Medical Devices Authority (TMDA) reports and other literature, only one report per 1 million inhabitants has been documented per year.11,12 This is contrary to the WHO average of reporting, which is 200 reports per million people. 13 Studies in South Africa, Tanzania, and Ethiopia have mentioned several challenges hindering spontaneous reporting of ADR, including a lack of enforcement on sensitization of the importance of reporting ADRs in both health care staff and PLHIV.7,12,14
Due to the high penetration of mobile phone use, the most common ways of communication in Tanzania are through phone calls and short message service (SMS) texts.15,16 Previous studies have shown that the use of digital tools, including SMS communication, might be a viable way to increase knowledge and understanding of reporting ADRs.17–19 In addition to high mobile phone penetration, SMS-based interventions offer significant advantages in low-resource settings: they are affordable, scalable, and can be personalized to individual needs. Recent mHealth research in Sub-Saharan Africa reinforces this promise. A 2023 pilot randomized trial in Kenya demonstrated that bidirectional, theory-informed SMS messages significantly supported ART adherence and viral suppression among women living with HIV. 20 A 2023 meta-analysis of randomized controlled trials also found that interactive SMS interventions consistently improved ART adherence, underscoring the importance of 2-way messaging for patient engagement. 21 Furthermore, a cluster randomized trial in South Africa showed that SMS reminders combined with peer navigation greatly improved linkage to HIV care among newly diagnosed adults. 22 Taken together, these findings suggest that SMS is not merely widespread, but an effective, evidence-based tool for enhancing ART adherence, retention, and, by extension, PV behaviors such as ADR reporting. In addition, it can remind all people involved in the disease management of PLHIV to report ADRs. Therefore, we designed an SMS system that triggered active reporting of ADRs in Tanzania and piloted the system among PLHIV. The overall objective was to investigate the feasibility and acceptability of using SMS to improve awareness of the importance of ADR reporting. Specifically, for feasibility, we compared the trend of the number of SMS sent/delivered/failed and replied to among the study participants. Considering acceptability, we analyzed qualitative data on questions about the use of SMS to report ADR among the study participants. Furthermore, we also explored the different ADR profiles that are reported.
Methods
Study Design
This was a mixed-methods study that employed a parallel design including quantitative and qualitative methods of data collection, conducted for 12 months from March 2019 up to March 2020.
Study Area
Participants were enrolled from 2 HIV care and treatment clinics, which are Kilimanjaro Christian Medical Centre (KCMC) and Majengo Health Center in the Kilimanjaro region, Tanzania. KCMC is a zonal hospital for the Northern zone in Tanzania, which has a care and treatment clinic for HIV serving more than 2000 clients per year. Majengo Health Centre is based in Moshi town, and the clinic serves around 1000 clients.
Study Population
The study population included 2 groups: (1) PLHIV and (2) healthcare workers (HCWs) who are serving PLHIV. The eligibility criteria for enrollment in the study of PLHIV were: age between 18 and 65, confirmed and documented HIV infection, patients on ART for less than 3 months or more than 12 months, attending a CTC (Care and Treatment Centre) at KCMC or Majengo Health Centre, and being able to read, understand SMS, and write SMS. Individuals who were critically ill or participating in other trials were excluded from the study. Participants who could not read SMS messages were excluded due to the design of the intervention involving reading and replying to text messages. We acknowledge this as a limitation, as it may have excluded a vulnerable subgroup. Eligibility criteria for the HCWs were: age between 18 and 65 years old and working at the CTC of KCMC or Majengo Health Center.
Sample Size Calculation
As this was a pilot study, we used a convenient sample size of 100 PLHIV.
This pilot study aimed to assess the feasibility and acceptability of SMS reminders for ADR reporting among adults living with HIV. As such, the sample size of 100 participants was determined based on logistical feasibility and the available clinic population during the recruitment period, rather than statistical power. While not powered for hypothesis testing, this sample size aligns with accepted norms for pilot studies aiming to assess usability and process outcomes. A total of 92 participants were ultimately enrolled after screening. Five HCWs were interviewed at the end of the study to collect data on their perceptions of the intervention. The HCWs that we interviewed included ART nurses and pharmacists who work at the clinics where the study was conducted. Their participation in the study during data collection and experience working in the clinics as explained in the data inventory, was an eligibility criteria for the interviews.
Study Procedures
General information on the study was provided to all participants while they waited for consultation at the clinic. Those who were interested were invited to meet with the study nurse for more information. After detailed information was given by the study nurse, participants who agreed to participate in the study signed informed consent and were enrolled in the study if they met all inclusion criteria. During enrollment, patients received an extensive explanation about ADR and what they are. This was to ensure that they knew what they would have to report.
To safeguard participant confidentiality, all SMS content was carefully worded to avoid disclosing sensitive health information. Participants were informed about the nature and timing of the SMS during enrollment. This was done to assure the participants received messages that they were comfortable with. All data collected through the SMS system were encrypted and stored on password-protected servers accessible only to the research team.
SMS Scheme
The SMS system was built in Telerivet SMS software, 23 which we programmed to send scheduled SMS to participants and receive replies. The SMS system sent automated biweekly SMS to participants. The messages were sent on Wednesdays every 2 weeks during the total study period. Once enrolled, participants received a welcoming message describing the importance of reporting any ADR. Then they received another follow-up SMS with the question asking, “How are you doing and if they had any symptoms?” Participants were required to respond to the questions with special characters that could be recognized by the SMS system. The characters included: 1. “I’m okay.” and 2. “I’m not okay.” If participants responded “2,” the system responded automatically with an SMS text stating the importance of reporting the symptoms and asking if they wanted to report the symptoms. If he/she replied with yes, the system asked to choose how they wished to report the ADR, choosing from the following options: (1) complete a web-based ADR reporting form, (2) complete a green form at the clinic, (3) receive a call from an HCW for completing the yellow form together, or (4) visit the clinic/wait till the next visit to complete the yellow form. A week later, a follow-up message was sent to ask if the symptoms were reported, and if answered with “yes,” which means of reporting was used.
Data Collection
We used RedCap software to collect the data. 24 After enrollment, baseline data were collected using a case report form, which included demographic data, including gender, age, education level, and phone number for receiving SMS.
In addition, data on HIV-related characteristics, such as type of ART taken, time of medication, and if there were any other medications taken, were collected. Follow-up after enrollment was done for up to 1 year during the standard clinic visits. Participants were interviewed every time they visited the clinic for their routine HIV care and treatment. Information about those who reported through SMS to have an ADR was shared with the nurses for further follow-up. Data were checked for completeness by a trained data manager on a daily basis. Data free of queries and missing variables were stored in our database, awaiting transfer to STATA for analysis. Missing details and queries were solved by collecting and verifying data using participants’ clinic files.
Qualitative Data
After 1 year of follow-up, we conducted in-depth interviews (IDIs) with HCWs about their experience with the intervention. The interviews were done in the local language (Kiswahili) by a research assistant (RA). The topic guides were developed by the study team and included issues that surfaced during the study. The following topics have been explored: experience with the system, usefulness of the system, technical issues, ease and difficulties, disadvantages/advantages, potential stigma, and appropriateness of the SMS. Additionally, focus-group discussions were organized with participants using the same topic list. Each focus group discussion (FGD) accommodated 8-10 participants with the following group characteristics: (1) women aged over 30, (2) women aged up to 30, (3) men aged over 30, and (4) men aged up to 30. The interviews and FGDs were recorded, transcribed, and translated by trained RA.
Acceptability was measured by the theoretical framework of acceptability developed by Sekhon et al. 25
Data Analyses
Data analysis of quantitative data was conducted using STATA Version 15.5. Descriptive analysis was done to summarize the demographic characteristics of the study participants in frequencies and percentages. To investigate the technical feasibility of the SMS system, we calculated the frequency and percentage of total SMS successfully sent and delivered and the number of failed SMS. Furthermore, we analyzed the preference for ADR reporting by determining the number of follow-up SMS on ADR and responded SMS on willingness to report ADR as well as means of reporting.
To investigate the acceptability of the system among HCWs and participants, all transcripts were read and re-read, and initial codes were produced. Discussions to harmonize the initial codes were done to produce a final codebook. Transcripts were uploaded to MAXQDA for coding. Later, thematic framework analysis with an inductive content approach was applied to analyze and extract the quotes from the transcripts. To explore the difference in reporting ADRs between groups, we summarized the most commonly reported ADRs.
Reporting Guidelines
This manuscript was prepared in accordance with relevant EQUATOR Network guidelines for mixed-methods research. The quantitative component of the study adheres to the Consolidated Standards of Reporting Trials (CONSORT) statement, including the extension for pilot and feasibility trials. 26
Results
Baseline Characteristics of the Study Population
Over 10 months, 114 participants were screened for eligibility, of which 10 (9%) did not meet the eligibility criteria and 12 (10%) declined participation. Among 92 participants enrolled in the study, 45 were from Majengo Health Centre and 47 were from KCMC. The mean age of our participants was 42 years (SD ± 12). Forty (43.5%) participants were on ART for less than 3 months, and the other 52 (56.5%) participants were on first-line ART. Participants from KCMC hospital reported more ADR than those at Majengo HC, while participants on second-line treatment encountered more ADR than those in the first line (Table 1).
Baseline Characteristics of Study Participants and Proportion of ADR Reporting (N = 92).
Abbreviations: ADR, adverse drug reactions; SD, standard deviation; ART, antiretroviral treatment.
Missing values frequency do not tally.
Preference of Route of ADR Reporting
A total of 105 follow-up SMS were sent to participants to ask if they encountered any ADR symptoms from their medications. Seventy-one (67.6%) SMS replied that they had a symptom after taking medications. Among them, 62 (87.3%) were willing to report the symptoms, 3 (4.2%) did not wish to report the symptoms, and 6 (8.5%) did not reply to the message on willingness to report ADR. A total of 42 (45.7%) participants reported visiting the clinic for reporting, 10 (16.1%) were called by the study nurse to report, and 8 (12.9%) reported ADR through the website (see Table 2).
Preference for ADR Reporting.
Abbreviation: ADR, adverse drug reactions.
Data Inventory
IDIs with Healthcare Providers
Five healthcare providers participated in the IDIs. Participants included both male and female providers from 2 types of health facilities: health centers and a referral hospital. Their professional experience ranged from 3 to 36 years. Two participants were from health centers with 5 and 36 years of experience, while 3 were from a referral hospital with 3 to 13 years of experience. The age range of participants was diverse, with one aged 60-65 years, two between 30 and 55 years, and two under the age of 30.
FGD Participants
A total of 27 participants were involved in the FGDs. The majority were female (74%, n = 20), and 26% (n = 7) were male. Participants had varied occupational backgrounds, including entrepreneurs, housewives, cleaners, farmers, and formally employed individuals. In terms of education, most had completed primary or secondary education, while a few had university education or no formal education at all. The median age of participants was 46 years, with an age range of 18 to 64 years.
Qualitative Results
Several themes came up during the IDI and FGD. Below, they have been described, including quotes from participants to illustrate each theme.
General Experience and Acceptability of the System
The general experience with the SMS system, including the SMS content and SMS frequency, was reported to be beneficial for reporting adverse reactions. For instance, on the topic of SMS content, the majority indicated that the contents were well understood, easy to follow, and effective to trigger them to report adverse reactions. This aligns with the percentage of SMS being replied to by the participants. Others described the content to be informative, particularly on means of reporting medication reactions. For instance, a woman in her 40s said: Yes, the SMS was very good. First, they reminded me to report if I have medication reactions, and second which means I should use it to report those events. I did not have any problem with the SMS contents, because the message didn’t state the word HIV or virus so it was okay. Also, if the system continues in the future, don’t change anything in the REMIND-ADR system.
This was described by a male in his 50s: I like the way the SMS was being sent with good information about how to report medication effects.
Also, he added: There was a time when the messages stopped being sent, while I wished them to continue. I felt very bad.
The Usefulness of the System
Participants were first asked how useful the system was in the context of triggering them to report.
Most of them reported that the system was useful because they were motivated by the SMS and felt being cared about their well-being. Others indicated that the system should continue even after the end of the project. One participant described: I had my phone with me all the time. So, when the messages came, I felt like I was being cared for by other people.
This was shown when the healthcare provider said: They were satisfied, because so many patients were able to get the message, reply to it and help even those who experienced side effects of the drugs to be able to detect early. It helped me to realize that it is my responsibility to talk to the patients and advise them about medication and, also, to tell them that if they see any problems after starting medication, they should report it. I came across a new case like the ones I told you about. The one who says he doesn’t see. The other person doesn’t feel like having sex. And, the man who got those hiccups. There was another we found. There was a woman who had a burn in her mouth. All these, we have never encountered before.
Ease of Reporting
Participants were asked to describe the way the system works based on their own experience. The majority described that the flow of the SMS through the system was easy and well understood by participants. Only 6 (8.5%) did not reply to the message on “willingness to report,” meaning that the majority understood how to reply. Most of the clients who got reactions indicated there were no difficulties in reporting, as the instructions were easy to understand. As mentioned by a male in his 50s: When I answer the question that I’m sick and I want to report the events, I was called by the nurse to go to the clinic. Yes, I had to stop the medication and use fruits, because the sleep was becoming too much and I was losing my strength, so I reported this.
Potential Barriers to Using the SMS
Although the majority described the system as good, a few themes emerged during the FGD discussions describing potential barriers. We saw from the SMS data that 5% of the study participants did not reply to the first message sent to them. One of these barriers was the poor network in some areas, which led to a delay or even failure in replying. Another barrier was not having an SMS bundle to reply to the messages. Despite that SMS bundles were being provided by the study throughout, some described that they did not get them. Hence, they were not able to reply.
A male in his 40s said: The number that I had registered was a [name of a network service provider] number. When I went to the village, I found no network. So, I was forced to have a sim card from a new provider. Sometimes I shared my phone with other people. So, when the message came, I felt like exposing REMINDER SMS might expose my status. Therefore, sometimes I deleted messages without reading them. The patient was changing the number. So, when you look for them on that number, you do not find them. So, you find the day you look for them again on the number maybe he receives. He says: “I changed the number.” We ask him for the number he uses currently. We ask them not to change numbers, but now everyone has the things they can still change. Sometimes, I see answering the message every time won’t help me. I don’t even see any benefit, despite the nurses advising that SMS were beneficial for my health and for other people as well. You know, the problem is the word “medication”. Maybe if it is kept in the plural. When you put it in the plural, you already remove someone from the meaning. Like, do you have any problem with the medications that you are using, simple and clear. Someone won’t understand the meaning. Since it might be aspirin or chloroquine. So it's just there in the singular and plural. They should write medication instead of medications. For example, when I tell you that I have reactions, you are supposed to tell me that the medication that you are using are causing the reactions, but you will be okay. So, even as I take it, I know that there is a day that I will be okay. However, when I say “yes” and then you keep quiet, on my side, the SMS is not good. Many people don’t even know where that document is on the website … they don’t know it at all.
There were also reporting inconsistencies, where patients failed to reply to SMS messages, sometimes without clear reasons. Many don’t even have any reason. Some just said, “I replied,” but if the SMS is not there you just know they didn’t reply.
Lastly, there were reflections on future scale-up and workload implications. Although the system was manageable during the pilot, providers anticipated that increasing awareness and coverage would add pressure: If we scale up, we must also increase the capacity of healthcare providers … with a great workload, the work cannot be done properly.
Discussion
This paper investigated the feasibility and acceptability of using SMS messages to improve awareness about the importance of ADR reporting using both qualitative and quantitative approaches.
Overall, we found that the majority of the participants who received the SMS question about whether they experienced ADR preferred to respond to the questions. Furthermore, when asked if they wanted to report the symptoms, the majority were found to be willing to report the symptoms through the web-based route. Even though the majority responded to the question in favor of the web-based tool, contrary to our expectations, the most used reporting strategy was clinic visits. Most adverse drug reaction (ADR) reports were reported during routine clinic visits. This discrepancy may be due to: limited digital literacy, unreliable internet access, and unfamiliarity with the online reporting platform. Additionally, some participants expressed greater trust in face-to-face interactions with healthcare providers, especially when discussing sensitive issues such as side effects. This suggests that while digital tools like web reporting may be appealing in theory, their practical use remains constrained by contextual and infrastructural limitations. The distinction between intention and behavior highlights the importance of user-centered design and blended reporting options that account for patient preferences and technical realities. Regarding experience, the majority expressed being satisfied with the SMS content, and it was related to an increase in their willingness to report ADRs. Also, a large percentage of participants expressed being motivated by the SMS to report the ADR, as the content of the SMS was found to be well understood and easy to respond to. The 2 ways of communication were found to improve the interaction between the HCWs and participants. Furthermore, participants indicated a strong preference for the biweekly reminders, as they felt to be cared for by someone.
A study from Kenya had a similar finding that a lower rate of ADRs was reported through the online route compared to reporting during the clinic visit. 27 Another study by Mir et al reported that the reasons for participants not reporting online are based on the perception that no action will be taken if the report is sent web-based. 28 A study in Ethiopia reported that personal contact with the study participants was associated with a higher number of reporting. 29 A study in Ghana revealed that the disparity in financial status and poor internet connectivity throughout Sub-Saharan Africa may lead to low rates of web-based reporting. 30 Studies conducted in Europe and Asia have shown that the preferred means of reporting are email and website due to the low cost of the internet and stable internet infrastructure. 30
It was also noted in our study that the patients at the referral hospital reported more ADRs compared with the health center. This could be due to a lack of awareness at the low facility levels. A study conducted in Ethiopia revealed insufficient knowledge of the existing PV system at health centers contributing to poor ADR reporting. 8 Another study in Kenya described that the availability of pharmacists in big hospitals likely encourages reporting, while health centers depend on nurses who have less knowledge about the PV systems. 27 Hanafi S et al suggest that a permanent ADR educational program is required for nurses in low-facility health centers to improve ADR reporting. 31
Moreover, in this study, we found that those who are on medication for more than 12 months report more compared to those on treatment for about 3 months. This suggests that being on treatment for a longer time might result in more ADR or more reporting and creates more awareness of ADRs. This is related to the previous study conducted in Ghana that showed that ART-experienced participants reported ADRs more frequently compared with those who just initiated the treatment. 30
Although the majority of participants described the SMS system as helpful and easy to use, several technical and social barriers were identified that affected engagement with the intervention. Approximately 5% of participants did not respond to the initial SMS, and multiple factors contributed to this limited responsiveness. Network connectivity issues were a recurrent barrier. Participants who traveled to rural areas reported difficulty accessing network services, which delayed or prevented SMS delivery. Additionally, SIM card changes without notifying the clinic disrupted message flow. This resulted in some participants not receiving reminders for adverse drug reaction (ADR) reporting. A healthcare provider explained the challenge of tracking patients who had changed numbers without updating their contact information. While SMS bundles were supplied by the study, some participants reported not receiving them consistently, limiting their ability to respond. Others faced phone-sharing dynamics, which posed risks of unwanted HIV status disclosure. In such cases, participants felt hesitant to open or respond to messages labeled as reminders. The language of the SMS content, specifically the word “medication,” was also noted as potentially stigmatizing and led some users to delete messages without reading them. Some participants viewed responding to SMS as pointless or burdensome, expressing that they saw no direct benefit. Moreover, participants were disappointed when the SMS system did not provide tailored feedback after a “Yes” response, expecting some form of reassurance or clinical advice. Our findings reflect broader implementation challenges documented in Sub-Saharan Africa. For instance, poor network coverage and unreliable electricity have delayed message delivery in Ethiopian reminder programs. 32 Phone-sharing practices and low digital literacy similarly limited engagement in Kenyan and Ugandan mHealth interventions. 33 In Cameroon, functional barriers, including inability to use SMS in the national language, prevented 15.6% of participants from engaging with health reminders. 34 Privacy concerns arising from SMS content have been observed among ART clients in Malawi. These parallels underscore the need for strategies like secure personalized messaging, inclusive language, and adaptive systems offering feedback rather than relying on rigid keyword replies.
Our study has some limitations. First, this was a pilot study that was conducted within a short period in 2 health facilities, and only a small sample size was included. We also excluded participants who could not read. Therefore, the results from this study cannot be generalized to the entire community. Future studies should consider a larger sample size to investigate effectiveness. We also used a convenient sampling technique to select our study participants, which we believe could lead to the risk of bias in our findings. This sampling technique is prone to researcher bias, limited external validity, and other unknown errors, which might have happened. In addition, we do not know the acceptability and feasibility of the intervention if it is implemented for a longer duration of time.
Second, in this study, we could not confirm if the reported symptoms from the patients were actual side effects of the drugs or were due to disease progression. Tests like liver function, kidney function, and other cholesterol tests were not performed in this study. Therefore, future studies need to perform tests for patients who report symptoms.
Additionally, participant responses may have been influenced by social desirability bias, particularly during interviews and SMS interactions. Moreover, as the study was conducted in an urban and semi-urban setting, the findings may not be generalizable to rural populations or other regions with differing mobile access and health system structures.
It should be considered that this study has several strengths. In addition, this was a mixed-methods study, which used quantitative and qualitative data to conclude the feasibility of using SMS service to report ADR in society.
Also, this study included both ART-naïve and treatment-experienced participants to determine if there could be differences in experiencing and reporting ADR. We collected data from both the participants and healthcare providers on their experiences of ADR reporting.
Conclusion
In this study, we saw that using the common way of communication, which is SMS, could be a viable way to increase knowledge and understanding of the importance of reporting ADRs. In addition, it can improve communication between all people involved in the disease management of PLHIV to address the potential risks of ADRs. The use of SMS is a low-cost intervention and a simple way to improve public health issues within society. The participants in this study managed to use the SMS platform to report if they encountered any medication side effects. As this was a pilot feasibility study, the results may serve for larger studies to investigate the effect of the SMS system on ADR reporting, and it may be scaled up to other regions and countries.
Supplemental Material
sj-doc-1-jia-10.1177_23259582251381868 - Supplemental material for A Mixed-Methods Pilot Study to Explore the Feasibility and Acceptability of SMS Reminders to Improve Adverse Drug Reaction Reporting among Adults on ART in Tanzania
Supplemental material, sj-doc-1-jia-10.1177_23259582251381868 for A Mixed-Methods Pilot Study to Explore the Feasibility and Acceptability of SMS Reminders to Improve Adverse Drug Reaction Reporting among Adults on ART in Tanzania by Lyidia Vedasto Masika, Naomi Emmanuel, Tumaini Mirai, Gloria Nyanungu, Mary Shirima, Marion Sumari-de Boer, Rehema Maro, Benson Mtesha and Kennedy Ngowi in Journal of the International Association of Providers of AIDS Care (JIAPAC)
Supplemental Material
sj-pdf-2-jia-10.1177_23259582251381868 - Supplemental material for A Mixed-Methods Pilot Study to Explore the Feasibility and Acceptability of SMS Reminders to Improve Adverse Drug Reaction Reporting among Adults on ART in Tanzania
Supplemental material, sj-pdf-2-jia-10.1177_23259582251381868 for A Mixed-Methods Pilot Study to Explore the Feasibility and Acceptability of SMS Reminders to Improve Adverse Drug Reaction Reporting among Adults on ART in Tanzania by Lyidia Vedasto Masika, Naomi Emmanuel, Tumaini Mirai, Gloria Nyanungu, Mary Shirima, Marion Sumari-de Boer, Rehema Maro, Benson Mtesha and Kennedy Ngowi in Journal of the International Association of Providers of AIDS Care (JIAPAC)
Footnotes
Acknowledgments
We appreciate all our study participants who consented to participate in our study. We also extend our sincere gratitude to all nurses and doctors at CTC sites, which were included in our study. We are grateful to the REMIND team at KCRI Tanzania for their endless efforts during the preparation and implementation of the study. This publication was produced by the REMIND ADR study, which is part of the EDCTP2 program (RegNet2015-1104-EACCR2) supported by the European Union. The views and opinions of authors expressed herein do not necessarily state or reflect those of EDCTP.
Ethical Approval
Ethical approval for the study was obtained from the Kilimanjaro Christian Medical University College Research and Ethics Committee (CRERC) with certificate No. 2612 and the National Health Research Ethics Sub-Committee (NatHREC) of Tanzania with certificate No. NIMRlHQIR.8a!V 01.IX/3183.
Informed Consent
Participants provided written informed consent prior to study entry after a detailed explanation of the study provided by study nurses. Privacy and confidentiality were assured throughout the study.
Author Contributions
LVM and NE drafted and revised the manuscript. TM, GN, and MS attended and collected quantitative data from our participants at the clinic. RM and NE worked on the qualitative part of the study. BM and LVM analyzed and interpreted the quantitative data. MSB and KN wrote the study protocol and the manuscript.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project is part of the EDCTP2 program (grant number RegNet2015-1104-EACCR2) supported by the European Union.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Supplemental Material
Supplemental material for this article is available online.
References
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