Effect of Digital Adherence Tools on Adherence to Antiretroviral Treatment Among Adults Living With HIV in Kilimanjaro, Tanzania: A Randomized Controlled Trial

Abstract

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Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence

“…Further, searching other sources led to the inclusion of 3 additional trials [ 48 – 50 ]. In total, we included 31 trials, of which 20 were published [ 19 – 35 , 43 – 45 ] and 11 were unpublished; six of the unpublished trials were finished [ 36 – 38 , 41 , 48 , 49 ] and 5 had an unknown status [ 39 , 40 , 46 , 47 , 50 ].…”

“…Trials were published between 2010 and 2021 and included a total of 16,924 participants (median: 846 participants per trial) [ 19 – 35 , 43 – 45 ] ( Table 1 ). For the eleven unpublished trials, ten trials planned to enroll a total of 11,639 participants (median: 1164 participants per trial) [ 36 – 41 , 46 – 50 ] ( Table 1 ), and one remaining trial did not report the planned number of participants to be enrolled [ 49 ].…”

“… *HR: Hazard ratio; †RD: Risk difference; § Only p-value reported/no p-value reported; ¶ Only adjusted results reported; || OR; Odds Ratio **Reported results from Clinicaltrials.gov/ISRCTN ††RR calculated based on 90% pharmacy refill (median), stated in table 4 in [ 45 ] …”

“…The mean age among trial participants ranged from 17 to 54 years. The primary target group for the text-message interventions were guardians of infant patients [ 19 , 20 , 24 , 25 , 36 , 37 , 39 , 40 , 46 , 47 ] where the mother was the receiver of the text message intervention, whilst the remaining trials solely targeted men [ 22 , 28 ] or women [ 32 , 33 , 35 , 44 , 46 , 48 – 50 ] or both men and women [ 23 , 26 , 27 , 29 – 31 , 34 , 38 , 41 , 43 , 45 ]. All trials were set in Sub-Saharan Africa with vast majority being set in Kenya (n = 17) followed by South Africa (n = 4) ( Fig 2 ).…”

“…The clinical areas in trials were HIV (n = 20), reproductive health (n = 4), antenatal health (n = 4), non-communicable diseases (n = 2), and malaria (n = 1). Ten trials reported that the text message content was developed based on health behavioral theories [ 19 , 24 , 28 , 30 , 32 , 34 , 35 , 37 – 39 ], eight reported that the content had been pre-tested or developed in consultation with experts, clinical staff and/or potential participants [ 21 , 23 , 25 , 26 , 31 , 39 , 44 , 46 ] and thirteen trials did not report either [ 20 , 22 , 27 , 29 , 33 , 36 , 41 , 43 , 45 , 47 – 50 ]. The content of the two-way text messages varied from supportive, educational, and motivational messages to reminders and quizzes with a two-way component of either replying to the message via text message or phone call or by requesting phone calls or additional information from the sender ( Table 1 ).…”