Use of a text message-based pharmacovigilance tool in Cambodia: pilot study

Sophie Baron, Flavie Goutard, Kunthy Nguon, Arnaud Tarantola, Sophie Baron, Flavie Goutard, Kunthy Nguon, Arnaud Tarantola

Abstract

Background: There is no functional pharmacovigilance system in Cambodia to our knowledge. Mobile phone-based tools, such as short message service (SMS) text messages, are increasingly used for surveillance purposes.

Objective: To pilot-test the FrontlineSMS mobile phone-based tool for notification of adverse events, using Cambodia's only International Vaccination Center at the Institut Pasteur du Cambodge as a field site.

Methods: People receiving vaccinations, aged over 18 years, and who owned a cell phone were recruited in the study following informed consent. The names and mobile phone numbers of the participants interviewed were entered each day into the FrontlineSMS software. Two days after being vaccinated, participants received an automatically generated SMS text message asking whether any adverse events had occurred. Their SMS reply was number-coded and exported from the software daily to an Excel spreadsheet and examined before being saved. If the participant replied with a code for a severe adverse event (8 or 9), they were automatically advised to consult the nearest doctor.

Results: The active surveillance study was conducted over 72 days in the spring of 2012. Patients agreed to be asked by SMS text message whether unwanted events had occurred after vaccination. Of 1331 persons aged over 18 years referred to the vaccination unit, 184 (13.8%) were asked and agreed to participate. When texted for clinical status 48 hours after vaccination, 52 (28.3%) participants did not reply, 101 (54.9%) sent an immediate SMS reply, and 31 (16.8%) sent an SMS reply after additional prompting. Of the initial 184 participants, 132 (71.7%) replied. These 132 participants received 135 vaccine doses and 109 (82.6%) reported no adverse events, whereas 23 (17.4%) reported adverse events, all benign.

Conclusions: Notification using an SMS-based text message system is already used in Cambodia for syndromic surveillance in health centers and reporting by health care workers. Our results show that such tools can also be useful for notification by patients or health users in Cambodia, especially in an urban setting.

Figures

Figure 1
Figure 1
Vaccination at the International Vaccination Center, Institut Pasteur du Cambodge.
Figure 2
Figure 2
The waiting room of the international vaccination center at the Institut Pasteur du Cambodge.
Figure 3
Figure 3
Number of health users at the international vaccination center and inclusions in the SMS pilot study, Institut Pasteur du Cambodge, March-May 2012.
Figure 4
Figure 4
Flowchart of patient recruitment in the pilot SMS text-based pharmacovigilance study at International Vaccination Center, Institut Pasteur du Cambodge, March-May 2012 (percentage total may not equal 100% due to rounding).

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Source: PubMed

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