Six billion. This was the world’s population at the turn of the century, and is now the estimated number of people with cell-phones across the globe.
Integrated into most people’s everyday lives, cell phones are increasingly recognized as a reliable and cost-effective way to improve and facilitate patient-provider communication and improve treatment adherence. Despite mobile health’s (mHealth) enormous potential, little is presently understood about mHealth’s capacity for large scale-up and whether it is truly sustainable in everyday clinical practice.
WelTel is a program that supports both research and public health initiatives that strive to integrate SMS (short-message-service or texting) into patient care. Dr. Richard Lester, an infectious diseases physician at the BCCDC and researcher at the University of British Columbia, founded the concept of WelTel in 2006.
The WelTel program uses a computer-to-SMS system to support patients by engaging both the clinician and the patient between appointments to promote medication adherence, and manage adverse reactions or general changes in health status. The system sends a weekly check-in text message (“How are you”?), and is designed to recognize negative responses, which prompt follow-up from the care provider.
Dr. Lester and his colleagues tested the efficacy of the WelTel service by conducting a multi-site randomized controlled trial among HIV-infected participants in Kenya. The trial showed that the weekly SMS model increased medication adherence as well clinically significant viral load suppression.(1) WelTel has now become integrated with other projects, both in BC and internationally, that support culturally sensitive care to improve retention before starting treatment and to maintain high adherence levels.
Dr. Lester and his team are working towards creating a WelTel program that will one day be implemented as a cost-effective model to manage chronic disease across many clinical practices and settings.
For further information about WelTel, please contact Dr. Lester at Richard.Lester(at)bccdc.ca.
- Richard T Lester, Paul Ritvo, Edward J Mills, Antony Kariri, Sarah Karanja, Michael H Chung, William Jack, James Habyarimana, Mohsen Sadatsafavi, Mehdi Najafzadeh. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. The Lancet, Volume 376, Issue 9755, Pages 1838-1845.