Assessing the Feasibility and Accessibility of mHealth Application for Supporting the Prevention, Treatment, and Management of Non-Communicable Diseases in Hai Duong Province, Vietnam

Abstract

Background: Non-communicable diseases (NCDs) are currently the leading cause of morbidity and mortality in Vietnam (defined by the WHO as 5 major groups of diseases: cardiovascular diseases, diabetes, chronic respiratory diseases, mental illnesses, and cancers), though limitations still exist regarding the delivery of effective primary care, creating the challenge of a double burden of disease. Mobile health (mHealth) and its role in improving the quality of clinical decision making, referrals, data collection and patient education have rapidly developed in the last decade. This study examines the feasibility and acceptability of mHealth application for supporting prevention, treatment and management of non-communicable diseases in rural Vietnam, as well as the opportunities and barriers to implementation of an mHealth-based intervention. Methods: A descriptive study using qualitative methodology was carried out, relying on a combination of semi-structured, in-depth interviews and focus group discussions involving multi-sectorial stakeholders and potential commune health center (CHC) level users in 1 rural province in Northern Vietnam. In total, there were 29 participants involved in focus groups and five in-depth interviews. Interview guides covered three main topics: 1) Current experiences and challenges of NCD education/management; 2) Baseline knowledge of mobile health and elements of acceptable SMS messages; 3) Expectations of and barriers to mobile phone use in NCD education/management. Results: In terms of current experiences related to NCD management, common themes amongst responders were the absence of a centralized system to track patient information, the difficulties of prioritizing in resource-limited settings, and patient expectation of a curative rather than preventive health system. One-way SMS was the preferred method of mHealth exchange. The preferred topics were disease prevention via risk factor education and appointment reminders, over medication reminders and information regarding diagnosis/management. Conclusion: This is the first qualitative study on the potential of mHealth to manage NCDs in rural Vietnam. While interest in mHealth as an innovative method to improve chronic health management in a resource-limited setting was significant, existing generational gaps in technology use and attitudes towards health systems remain significant barriers to implementing mHealth. While one-way SMS message may eventually become a complementary method in patient education, mHealth cannot replace conventional heath care. The study was small, with participation based on availability and highlights difficulties to introducing new technology, but may not be broadly generalizable.