Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
No Thumbnail Available
Date
2012-09-06
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND Adherence is central to the success of antiretroviral therapy Supporting adherence has gained importance in HIV care in many national treatment programs The ubiquity of mobile phones even in resource constrained settings has provided an opportunity to utilize an inexpensive contextually feasible technology for adherence support in HIV in these settings We aimed to assess the influence of mobile phone reminders on adherence to antiretroviral therapy in South India Participant experiences with the intervention were also studied This is the first report of such an intervention for antiretroviral adherence from India a country with over 800 million mobile connections METHODS STUDY DESIGN Quasi experimental cohort study involving 150 HIV infected individuals from Bangalore India who were on antiretroviral therapy between April and July 2010 The intervention All participants received two types of adherence reminders on their mobile phones i an automated interactive voice response IVR call and ii A non interactive neutral picture short messaging service SMS once a week for 6 months Adherence measured by pill count was assessed at study recruitment and at months one three six nine and twelve Participant experiences were assessed at the end of the intervention period RESULTS The mean age of the participants was 38 years 27 were female and 90 urban Overall 3 895 IVRs and 3 073 SMSs were sent to the participants over 6 months Complete case analysis revealed that the proportion of participants with optimal adherence increased from 85 to 91 patients during the intervention period an effect that was maintained 6 months after the intervention was discontinued p 0 016 Both IVR calls and SMS reminders were considered non intrusive and not a threat to privacy A significantly higher proportion agreed that the IVR was helpful compared to the SMS pUnder0 001 CONCLUSION Mobile phone reminders may improve medication adherence in HIV infected individuals in this setting the effect of which was found to persist for at least 6 months after cessation of the intervention