Sponsor
The study was funded by a grant from the US National Institutes of Health (R34MH100940). The study was registered with ClinicalTrials.gov (NCT01957865).
Published In
AIDS
Document Type
Article
Publication Date
1-2016
Subjects
AIDS (Disease) -- Treatment -- Uganda, AIDS (Disease) -- Uganda -- Clinical trials, Antiretroviral therapy, AIDS (Disease) -- Patients -- Counseling of
Physical Description
5 pages
Abstract
Objective: To explore the effects of four types of short message service (SMS) plus realtime adherence monitoring on antiretroviral therapy (ART) adherence: daily reminders, weekly reminders, reminders triggered after a late or missed dose (delivered to patients), and notifications triggered by sustained adherence lapses (delivered to patient-nominated social supporters).
Design: Pilot randomized controlled trial.
Methods: Sixty-three individuals initiating ART received a real-time adherence monitor and were randomized (1 : 1 : 1): (1) Scheduled SMS reminders (daily for 1 month, weekly for 2 months), then SMS reminders triggered by a late or missed dose (no monitoring signal within 2 h of expected dosing); SMS notifications to social supporters for sustained adherence lapses (no monitoring signal for >48 h) added after 3 months. (2) Triggered SMS reminders starting at enrolment; SMS notifications to social supporters added after 3 months. (3) Control: No SMS. HIV RNA was determined at 9 months. Percentage adherence and adherence lapses were compared by linear generalized estimating equations and Poisson regression, respectively.
Results: Median age was 31 years, 65% were women, and median enrolment CD4þ cell count was 322 cells/ml 97% took once daily tenofovir/emtricitabine/efavirenz. Compared to control, adherence was 11.1% higher (P¼0.04) and more than 48-h lapses were less frequent (IRR 0.6, P¼0.02) in the scheduled SMS arm. Adherence and more than 48-h lapses were similar in the triggered SMS arm and control. No differences in HIV RNA were seen.
Conclusion: Scheduled SMS reminders improved ART in the context of real-time monitoring. Larger studies are needed to determine the impact of triggered reminders and role of social supporters in improving adherence.
DOI
10.1097/QAD.0000000000001021
Persistent Identifier
http://archives.pdx.edu/ds/psu/18527
Publisher
Wolters Kluwer Health, Inc.
Citation Details
110. Haberer JE, Musiimenta A, Atukunda EC, Musinguzi N, Wyatt MA, Ware NC, Bangsberg DR. SMS reminders plus real-time adherence monitoring improve adherence to antiretroviral therapy in rural Uganda. AIDS 2016, 30:1295-1299
Description
At the time of writing, David Bangsberg was affiliated with Massachusetts General Hospital, Boston; Harvard Medical School, Boston; Mbarara University of Science and Technology;, and Harvard TH Chan School of Public Health.
Copyright © 2016 Wolters Kluwer Health, Inc.