Family Medicine Trainers’ Experience with Cell Phone Use in Primary Care in Nigeria

摘要

BackgroundMobile phones are common communication tools which have found relevance in healthcare delivery and training in developed countries. Their relevance in healthcare systems of developing countries like Nigeria remains speculative. Postgraduate medical doctors’ trainers’ experience in the use of this technology in healthcare service delivery may provide information on how these devices can be used to improve both training and health service delivery in Nigeria.ObjectivesThe objectives of this study were to describe Family Medicine Trainers’ Experience, ownership, and related cost in the use of mobile cell phones in outpatient care. The study also sought to identify challenges with cell phone use in patient care.MethodsA survey of 125 Family Medicine Trainers in Nigeria was carried out to ascertain experience, ownership, and related costs with the use of mobile phones in patients receiving outpatient care. Of the 125 self-administered questionnaires distributed with 109 returned, only 107 found suitable were analysed to ascertain proportions of these variables.ResultsAll the 107 (100%) Family Medicine Trainers had a mobile cell phone with 99 % of them having smartphones. About 91% of trainers had high self-reported knowledge of cell phone functions and 98% had provided cell phone related care to patients. Key services rendered were scheduling of appointments by 88% of trainers, prescription of medications 85%, counselling on lifestyle changes 72%; advice on general disease symptoms by 71% and handling of laboratory results by 64% of trainers. However, the majority (67%) of trainers provided these services to less than 10% of their patients monthly. The trainers spent on average N8,000 (USD$ 40) on mobile cell phone use monthly and there is no payment mechanism for the provision of these services to patients.ConclusionNinety-eight percent (98%) of trainers had cell phone related patient care experience but patients’ coverage with such service is low. Addressing cost and mechanism of payment for such services have the potential to improve coverage and efficiency of this aspect of service delivery. Introduction Mobile cell phone use in healthcare is on the increase globally and clinicians, especially physicians, have begun to deploy the technology in patient care with good patients’ outcomes1,2,3.Recently, a study in Nigeria on the ownership and use of cell phones among Family Medicine Residents revealed that 96.8% of resident doctors owned smartphones and were using them to provide some aspect of outpatient medical care4. Mobile Phone technology is poised to enable a new era in healthcare delivery globally and in Nigeria where the National Household and Demographic Survey (NHDS) revealed that 75% of households own a cellphone5,6.Almost all mobile phones provide Short Message Service (SMS) commonly known as text messaging, and Multimedia Message Service (MMS) for transmitting graphics, video clips and sound graphics. SMS has developed into an essential communication medium especially among younger adults in developing countries 7. Available records showed that the total number of text messages sent globally rose from 1.8 trillion in 2007 to 6.1 trillion in 2010, a threefold rise in utilization of this medium and an average of 200,000 messages every second7. These short messages usually up to 160 characters are sent through mobile phones or from internet to mobile phones of the receivers.Text messages have instant transmission and low cost when compared to other communication channels. There is also a relatively low chance of being misplaced and they are less invasive to daily lives when compared to phone calls8. Mobile phones robust features of mobility, ubiquity, direct and instantaneous access coupled with communication have promoted their use in health information transfer resulting in increased access to healthcare; improved diagnosis and treatment; enhanced efficiency of service delivery and promotion of self-care9,10.