Jonathan to speak at Global Public Health & Technology Conference
Jonathan will be speaking on a panel on ICTs for CHWs at the Global Public Health & Technology Conference at the Harvard Kennedy School on May 1st.
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ARemind orally presented at IAPAC 2009
Dr. Helene Hardy presented one of the select oral abstracts at the 4th International Conference on HIV Treatment Adherence in Miami:
Title: Assess and Remind (ARemind): a Personalized Cell Phone Reminder System is Superior to a Beeper to Enhance Adherence to Antiretroviral Therapy
Background: Adherence to antiretroviral therapy (ART) represents one of the strongest predictor of progression to AIDS, yet innovative technologies are needed to sustain adherence over time. The purpose of this study was to compare the efficacy of a personalized cell phone reminder system called Aremind in enhancing adherence to ART versus a beeper.
Methods: Twenty-three HIV-infected subjects on ART with self-reported adherence <85% were randomized to a cellular phone (CP) or beeper (BP). CP subjects received personalized text messages and had to respond with a text message when taking ART. BP subjects received a reminder beep at the time of dosing. Interviews were schedule every 3 weeks over 6 weeks. Adherence to ART was measured by self-report (SR, 7-day recall), pill count (PC, past 30 days at baseline, then past 3 weeks), and MEMS (cumulatively at 3 and 6 weeks). ANCOVA model adjusted for baseline adherence was used to compare SR and PC adherence changes. T-test was used to evaluate difference between groups for MEMS.
Results: Twelve males and 11 females were enrolled; 19 completed all visits. Mean baseline viral load and CD4 count were 21,309 copies/mL and 295 cells/mm3. Most subjects were on a boosted PI (52.2%) or an NNRTI (17.4%). Past adherence barriers included active substance abuse (73.9%), fear of side effects (69.6%), and lack of daily routine (65.2%). Both SR and PC adherence increased significantly from baseline to week 6 in the CP arm (83.4% to 92.8%, p=0.03; 65.2% to 82.8%, p=0.005). Furthermore, cumulative MEMS adherence (88% vs 60%, p=0.008), average SR adherence (92% vs 75%, p=0.07), and average PC adherence (80% vs 65%, = 0.06) were higher in the CP arm.
Conclusions: Aremind was more successful than a beeper in enhancing adherence to ART in this population. A larger prospective study is necessary to confirm these findings.
Citation: Hardy H, Farmer EK, Kumar V, Jackson J, Myung D, Doros G, Rybin D, Drainoni M, Backman E, Stanic A, Skolnik P. Assess and Remind (ARemind): a Personalized Cell Phone Reminder System is Superior to a Beeper to Enhance Adherence to Antiretroviral Therapy. Fourth International Conference on HIV Treatment Adherence. April 5-7, 2009, Miami, Florida. Abst 0289. Approved for Oral Presentation
Innovate Locally, Create Businesses Globally
I spoke at the MIT Tech Review’s inaugural conference (emtech) in India recently on a bottom of the pyramid technology panel with Prof. Anil Gupta from IIM-A and the Honey Bee Network and Sanjay Swamy of mCheck.
The Honey Bee network has shown great examples of innovation BY the bottom of the (economic – as Dr. Gupta asserts) pyramid. Check out this video.
Very cool. Also the innovations are very distributed across the country. This reinforces the idea that innovation is a local exercise. Primarily because identifying problems is a very local process.
That said, I strongly believe that business can be created globally. It certainly helps to know local to sell local, but access to local markets happens through networks of the right people and businesses. They are linked through funny ways – eg., we have done nearly no in-country sales trips for Dimagi but have business in 9 countries across the world.
So while I think you’re more likely to create the right tree-climbing solution when you’re surrounded by coconut trees, I believe you can be sitting in Boston or London and contribute to build a successful business that commercializes that technology. Prof. Gupta has done a tremendous job promoting local innovation. The world of entrepreneurs need to tap into these innovations and take them global.
Social Enterprise Conference at Harvard
There is a Social Enterprise Conference at HBS this weekend on Sunday, 3/1. For those in the Boston area, it looks like they have lined up a great set of panels and speakers. Including the CEO and co-founder of Endeavor, Linda Rottenberg, who I’ve been told gives a great talk.