63
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Text Message Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A Meta-Analysis of Randomized Controlled Trials

      research-article
      * , ,
      PLoS ONE
      Public Library of Science

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The efficacy of antiretroviral therapy depends on patient adherence to a daily medication regimen, yet many patients fail to adhere at high enough rates to maintain health and reduce the risk of transmitting HIV. Given the explosive global growth of cellular-mobile phone use, text-messaging interventions to promote adherence are especially appropriate. This meta-analysis synthesized available text messaging interventions to promote antiretroviral therapy adherence in people living with HIV.

          Methods

          We performed Boolean searches of electronic databases, hand searches of recent year conference abstracts and reverse searches. Included studies (1) targeted antiretroviral therapy adherence in a sample of people living with HIV, (2) used a randomized-controlled trial design to examine a text messaging intervention, and (3) reported at least one adherence measurement or clinical outcome.

          Results

          Eight studies, including 9 interventions, met inclusion criteria. Text-messaging interventions yielded significantly higher adherence than control conditions (OR = 1.39; 95% CI = 1.18, 1.64). Sensitivity analyses of intervention characteristics suggested that studies had larger effects when interventions (1) were sent less frequently than daily, (2) supported bidirectional communication, (3) included personalized message content, and (4) were matched to participants’ antiretroviral therapy dosing schedule. Interventions were also associated with improved viral load and/or CD4+ count ( k = 3; OR = 1.56; 95% CI = 1.11, 2.20).

          Conclusions

          Text-messaging can support antiretroviral therapy adherence. Researchers should consider the adoption of less frequent messaging interventions with content and timing that is individually tailored and designed to evoke a reply from the recipient. Future research is needed in order to determine how best to optimize efficacy.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: not found
          • Article: not found

          Non-adherence to highly active antiretroviral therapy predicts progression to AIDS.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression.

            For antiretroviral therapy, the 95% adherence "threshold" is based on nucloside-exposed patients who are receiving partially suppressive, unboosted protease inhibitor regimens. Using unannounced pill counts and electronic medication monitoring, viral suppression is common with a 54%-100% mean adherence level to nonnucleoside reverse-transcriptase-inhibitor regimens. Although perfect adherence is an important goal, viral suppression is possible with moderate adherence to potent regimens.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Adherence to highly active antiretroviral therapy (HAART): a meta-analysis.

              This meta-analysis synthesizes eighty-four observational studies, conducted across twenty countries, to determine the mean proportion of people who reported ≥90% adherence to prescribed highly active antiretroviral therapy (HAART) and to identify the factors associated with high levels of adherence. Eight electronic databases were searched to locate all relevant studies available by January 2010, which were then coded for sample characteristics and adherence levels. The average rate of reporting ≥90% adherent HAART adherence is 62%. However, this proportion varies greatly across studies. In particular, a greater proportion of individuals maintaining ≥90% adherence to HAART is more likely in studies with higher proportions of men who have sex with men (MSM) and lower proportions of injection drug users (IDU), with participants in an earlier stage of infection, and in studies conducted in countries characterized by lower Human Development Index (HDI) scores.
                Bookmark

                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                5 February 2014
                : 9
                : 2
                : e88166
                Affiliations
                [1] Department of Psychology, Center for Health, Intervention, & Prevention (CHIP), University of Connecticut, Storrs, Connecticut, United States of America
                Imperial College London, United Kingdom
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: DJF BTJ. Performed the experiments: DJF JAP. Analyzed the data: DJF BTJ. Contributed reagents/materials/analysis tools: DJF BTJ. Wrote the paper: DJF JAP BTJ.

                Article
                PONE-D-13-33524
                10.1371/journal.pone.0088166
                3914915
                24505411
                2b880d17-5220-40ec-bd85-c69210e7b507
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 August 2013
                : 6 January 2014
                Page count
                Pages: 10
                Funding
                This research was supported by U.S. Public Health Service Institutional National Research Service Award T32-MH074387 (PI: Seth C. Kalichman; trainees: David J. Finitsis and Jennifer A. Pellowski) and grant R01-MH58563 (PI: Blair T. Johnson). http://www.nimh.nih.gov/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine
                Global Health
                Infectious Diseases
                Viral Diseases
                HIV
                HIV prevention
                Non-Clinical Medicine
                Medical Communication
                Public Health
                Behavioral and Social Aspects of Health
                Social and Behavioral Sciences
                Psychology

                Uncategorized
                Uncategorized

                Comments

                Comment on this article