One-Way and Two-Way Mobile Phone Text Messages for Treatment Adherence Among Patients With HIV: Protocol for a Randomized Controlled Trial

Abstract

Background Incomplete adherence to antiretroviral therapy (ART) is one of the factors that contribute to HIV drug resistance, and it is a major problem for the public health system in controlling the HIV pandemic. There is emerging evidence that SMS can play an important role in health care delivery among patients with HIV on ART, especially in resource-limited settings. Objective This paper aims to assess the impact of two-way and one-way SMS text messaging on adherence to HIV treatment. We hypothesized that sending weekly text messages through the one-way and two-way SMS text messaging approach will improve adherence to ART among patients with HIV and improve associated clinical outcomes (quality of life). Methods A randomized controlled trial is being carried out among participants with HIV who have been on ART for at least one month from an accredited treatment center, namely the Buea Regional Hospital and Kumba District Hospital of South West Region, Cameroon. Participants with HIV, both male and female, aged 21 years and older make up a sample size of 207. The interventions involved the use of mobile phone text messages. Before commencing the intervention, a focus group discussion was carried out among the participants to understand their perception about the use of SMS-based interventions to improve adherence. A total of 246 participants were randomized to receive either a one-way text message (SMS sent to a recipient without recipient sending a reply) or two-way text message (SMS sent to a recipient and recipient sends a reply) or the control (no SMS, only standard care). Data on adherence and quality of life were collected at baseline and after 6 months and will be analyzed using SPSS version 21, while qualitative data will be analyzed using Atlas.ti 7.5. Results Data collection began in September 2019 with focus group discussions and baseline data collection. After 1 month of baseline data collection, the intervention began in October 2019, and postintervention data were collected after 6 months (March 2020). At the end of the study, we will be able to understand the perception of patients toward SMS text messaging–based interventions and also assess the impact of one-way and two-way SMS text messages on treatment adherence among patients with HIV and on associated clinical outcomes (quality of life). Conclusions The impact of SMS text messaging varies across different settings. The results from this study will determine the perception of patients toward an SMS text messaging–based intervention and its impact on adherence to ART. International Registered Report Identifier (IRRID) DERR1-10.2196/16127

Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review

“…Some of the secondary outcomes include retention in care and QoL. A study protocol [ 44 ] aims to assess the impact of two-way and one-way SMS text messaging on adherence to HIV treatment in the Cameroonian population. The primary outcome is treatment adherence while the key secondary outcome is QoL.…”

Treatment Adherence among HIV and TB Patients Using Single and Double Way Mobile Phone Text Messages: A Randomized Controlled Trial

“…These are state-owned hospitals accredited with HIV and TB treatment centers. These hospitals accommodate patients from other areas of the South West Region, providing health services to more than 10,000 inhabitants from this part of the country [ 15 ].…”

“…In order to make up for the 19 that were assumed to be lost to follow-up, we added the 19 participants to the calculated 63 participants, giving a total of 82 participants. Therefore, a minimum of 246 participants were recruited for the study [ 15 ].…”

“…The study protocol including the methods section has been published as a preprint in ResearchGate and as an article in the Journal of Medical Internet Research [ 14 , 15 ].…”

“…HIV and TB participants were randomly assigned to the intervention groups and control groups. The control group received only the treatment and the standard care provided at the treatment centers [ 15 ].…”