Patient-Specific Mobile Phone-Generated Reminders and Quality of Hypertension Care in Western Kenya Nicholas KIRUI a,b,1 , Jemimah KAMANO c , Simon SAVAI b , Lawrence MISOI a , Steven RONO d and Martin C. WERE e a Department of Medicine, Moi Teaching and Referral Hospital, Eldoret, Kenya b Institute of Biomedical Informatics, College of Health Sciences, Moi University, Eldoret, Kenya c Department of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya d Academic Model Providing Access to Healthcare, Eldoret, Kenya e Vanderbilt University Medical Center, 2525 West End Avenue, Suite 750, Nashville, Tennessee 37203, US ORCiD ID: Nicholas Kirui https://orcid.org/0000-0003-1382-7165, Simon Savai https://orcid.org/0000-0001-6353-0904, Martin C. Were https://orcid.org/0000-0002- 6182-093X Abstract. To evaluate the impact of clinician-targeted mHealth-generated care suggestions on compliance with hypertension care guidelines in a resource-limited setting. This study was conducted in 10 rural health clinics in Western Kenya that offered hypertension care through nurses and clinical officers. Sites were grouped into intervention and control groups. Intervention group clinicians had patient- specific care suggestions triggered and displayed on a mobile application, mUzima, for their action. Care suggestions were also triggered in the mHealth application for control arm clinicians but were not displayed. Differences in compliance with hypertension care guidelines were evaluated. The study involved 378 patients with hypertension who had care suggestions generated during visits (217 in intervention group and 161 in control group). There was a higher proportion of adherence to hypertension care guidelines in the intervention group compared to the control group (91.1% vs. 85.7%, p=0.014). The random effects model showed significant variability in compliance rates among study clinicians (variance of 0.44, 95% CI: 0.12 -1.62). When displayed care suggestions were rejected by intervention providers, the most common reason given was ‘Previously ordered’ (58.8%). Clinicians felt that care suggestions improved awareness of hypertension care guidelines. The successful scaled implementation of mUzima with patient specific care suggestions led to higher adherence to hypertension care guidelines and improved quality of hypertension care. Tailormade m-Health applications in resource constrained settings for hypertension care and other chronic non- communicable diseases has the potential to lead to better adherence to care guidelines and quality of care. Keywords. Clinical decision support, chronic disease, mHealth, low- and middle- income countries 1 Corresponding Author: Nicholas Kirui, MBChB, MMed, MSc (HI), Department of Medicine, Moi Teaching and Referral Hospital, P.O Box 3 - 30100, Eldoret Kenya, Tel. +254 721 996525; email: kirui.leitich@gmail.com. MEDINFO 2023 — The Future Is Accessible J. Bichel-Findlay et al. (Eds.) © 2024 International Medical Informatics Association (IMIA) and IOS Press. This article is published online with Open Access by IOS Press and distributed under the terms of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0). doi:10.3233/SHTI230966 254