Desenvolvimento de um sistema de código aberto de envio de mensagens de texto (SMS) para intervenções clínicas em doenças crônicas não transmissíveis

Abstract

Chronic Noncommunicable Diseases (NCDs) are the leading cause of death in the world, and have generated a high number of premature deaths, loss of quality of life, and economic impacts for society in general, both directly (hospitalizations, medications, treatments) and indirectly (loss of production, early retirement). Different factors may be associated with adherence to treatment of patients with long-term therapies, including the use of medications, changes in lifestyle and eating habits. Mobile Health (mHealth) is the use of mobile phone technology to provide health care; the technologies that have been used for mHealth include text messages, video messages, voice calls and Internet connectivity. The use of Short Message Service (SMS) allows instant delivery of text messages directly to users at anytime and anywhere. Although SMS can be reproducible in large quantities, it can also be personalized for each receiver, thereby circumventing the likelihood of the message being dismissed as irrelevant; moreover, it can be read in a timely manner by each individual, overcoming some of the drawbacks associated with receiving phone calls. Thus, the primary objective of this dissertation was to develop an open source system for the management of sending customized text messages (SMS) targeting clinical interventions aimed at patients with chronic diseases. As a secondary objective, reliability tests will be performed in the SMS management system, with time records of receipt and number of delays. This messaging system is already in full operation, with all the above features working, thereby covering the first phase of the project. Access can be made through the following URL: http://smsaude.webbyapp.com/. Currently, two doctors are using the tool for sending SMS to their patients, that are included in research projects related to Federal Fluminense University (UFF). Regarding the reliability tests, 1301 messages have been sent, divided among five phones; only three messages were received late (0.23%), and there was an average of 05 min 50 sec in advance for the receipt of the message. Although there are some systems for sending SMS facing the health sector in the market, none of the software was developed in an open source model, ie, allowing its modification and / or free distribution. Moreover, there are no scientific studies demonstrating the quality of these tools, or even testing its effectiveness in the target population. Faced with the challenge of seeking greater medication adherence, this project therefore aims to expand the potential use of text messaging in the context of health care, acting as a complementary tool in the clinical intervention of NCDs, being widely accessible and inexpensive, and assisting the patient in understanding and self-management of their comorbidity.