Recent developments in mobile health technologies have transformed health care delivery and improved health outcomes. Bolta Parcha, meaning ‘Talking Prescription’ is a research project which aims to assess the effectiveness of mHealth tools and technologies in increasing medication adherence and health literacy in patients with cardiovascular diseases in Pakistan.
Pakistan is a country at a high risk of cardiovascular diseases and also has one of the lowest literacy rates globally - a combination which results in high morbidity and mortality. Patients, who are often illiterate, find it difficult to follow or understand medical prescriptions, written in English as opposed to the local language. Also, due to an unregulated health industry, patients frequently take multiple opinions and prescriptions from different physicians. Resultantly, the lack of understanding leads to poor adherence to life-saving medications and increases their risk for recurrent events, drug-drug interactions and serious adverse reactions.
The Aga Khan University Stroke Service, Baylor College of Medicine and AKDN eHRC collaborated to develop and pilot a Talking Prescriptions (Talking Rx) IVR and SMS reminder system. The system allows patients to access tailored voice messages while customised SMS medication reminders are sent to increase medication compliance and health literacy. The Bolta Parcha research project focuses on assessing the effectiveness and acceptability of the system by patients suffering from vascular diseases.
Bolta Parcha consists of two types of applications, which are integrated with each another: a desktop-based imaging application, which digitises prescriptions into image files for the system to read and the web-based medical record application, which registers patients and stores and transmits the patient’s pharmacy data to other messaging servers. The platform also includes a messaging and voice server, which allows storage and binding of audio files. The system allows patients to receive guidance and information on their dosage, possible side effects, drug interactions and reasons for medication use. The following video illustrates how Bolta Parcha works:
mHealth interventions like Bolta Parcha have the potential to improve patient experience and reduce health care costs, resulting in improved health outcomes for resource-poor settings like Pakistan. Pilot testing for Bolta Parcha was completed in 2015. During 2016, data analysis and reporting was concluded with early favorable results. A larger, multicentre trial is planned for the project.
Bolta Parcha is fully-funded by the Baylor College of Medicine Center for Globalization on grants awarded to a team of international AKU alumnus, Dr Salim Virani, and national AKU alumnus, Dr Ayeesha Kamran Kamal and a team of biomedical engineers and design developers from AKDN eHRC.
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