Adapting SMS-Based Pharmacovigilance Strategies From Tanzania to the Philippine ART Program

Abstract

This letter comments on the study by Masika et al, which demonstrated the feasibility of SMS reminders to improve adverse drug reaction (ADR) reporting among adults on antiretroviral therapy (ART) in Tanzania. Their findings show how mobile messaging can enhance patient awareness and strengthen pharmacovigilance in resource-limited settings. This commentary considers the relevance of this approach for the Philippines, where ADR underreporting persists due to limited digital tools, uneven facility resources, and low patient engagement. With mobile phone penetration exceeding 130%, an SMS-based system could provide an accessible and scalable method for supporting timely ADR reporting among people living with HIV. Adapting the Tanzanian model, while ensuring cultural appropriateness, confidentiality, and integration with national reporting mechanisms, may help address gaps in treatment monitoring and contribute to a more responsive, data-driven ART program.

Plain Language Summary

Using Text Messages to Help People With HIV in the Philippines Report Medication Side Effects

Taking HIV medicine can sometimes cause side effects, which can affect a person's health and make it harder to stick to treatment. Reporting these side effects to healthcare providers is important, but many people in the Philippines do not always report them because of limited awareness, busy clinics, or worries about privacy. A recent study in Tanzania showed that sending text messages (SMS) to people with HIV can help them report side effects more easily. Participants received simple messages asking about their health, and they could reply if they experienced any problems. The system was easy to use, well understood, and widely accepted. Inspired by this approach, using SMS reminders in the Philippines could make it easier for people living with HIV to report side effects quickly. Messages can be tailored to be clear, culturally appropriate, and confidential. Connecting this system to digital health records would allow healthcare providers to respond quickly and adjust treatment if needed. This approach is low-cost, simple, and can reach people even in remote areas. By helping people report side effects early, SMS reminders can improve safety, treatment success, and overall health for people living with HIV. Lessons learned in the Philippines could also be applied in other countries facing similar challenges, showing how mobile technology can improve HIV care worldwide.

Dear Editor,

I read with great interest the recently published article, “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 Masika et al. ¹ Their work provides compelling evidence that SMS-based reminders can strengthen patient awareness of adverse drug reactions (ADRs) and improve reporting among people living with HIV (PLHIV).

I wish to highlight the relevance of these findings to the Philippine context, where similar challenges in ADR reporting persist. Although antiretroviral therapy (ART) coverage continues to expand, the Philippines still faces difficulties in ensuring consistent ADR reporting. Limited patient awareness, fragmented reporting systems, and resource constraints in treatment hubs contribute to persistent underreporting—an issue well documented in global pharmacovigilance literature.^2,3

Masika et al's findings offer a promising model for adaptation. Their SMS-based system empowered PLHIV to self-report symptoms, reinforced awareness of ADRs, and reduced reliance on facility-based follow-up. The patient-centered nature of this approach is particularly relevant for countries such as the Philippines, where many PLHIV face mobility, stigma, and resource barriers that hinder in-person reporting.

The Philippines presents favorable conditions for such an intervention. With mobile phone penetration exceeding 130%, SMS remains one of the most accessible and dependable communication channels in both urban and remote settings. Implementing SMS-based reminders could therefore strengthen patient engagement in pharmacovigilance, enhance symptom reporting, and improve linkage to care, especially in settings where electronic medical records and online reporting platforms remain inconsistent. ²

Improving ADR reporting is particularly urgent in the Philippines due to factors such as polypharmacy, tuberculosis co-infection, and uneven access to ART regimens. These conditions heighten the risk of drug interactions and adverse events, underscoring the importance of timely monitoring. Studies have long emphasized that underreporting of ADRs slows public health response, compromises drug safety, and weakens treatment programs.^3,4

Furthermore, integrating SMS-based pharmacovigilance aligns with World Health Organization recommendations on the responsible adoption of digital health technologies and patient-centered reporting systems. ⁵ With contextual adaptation, such as incorporating local languages, ensuring confidentiality, and embedding the system within existing reporting platforms, this approach could significantly strengthen the Philippine ART program.

The SMS-based model demonstrated by Masika et al offers insights with clear relevance beyond the Tanzanian context. In the Philippines, adapting a similar strategy could enhance ADR reporting, strengthen patient participation, and support the development of a more responsive, data-informed HIV care system. Exploring a pilot implementation within selected treatment hubs may help determine its feasibility and value for the national ART program.