Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda

Haberer, Jessica; Musiimenta, Angella; Atukunda, Esther C; Musinguzi, Nicholas; Wyatt, Monique A.; Ware, Norma C.; Bangsberg, David R.

doi:10.1097/qad.0000000000001021

Cited by 145 publications

(171 citation statements)

References 17 publications

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“…Some of this bias can be reduced in analyzing the adherence data (e.g., censoring more openings than would be expected per day). Additionally, complementing adherence monitoring with assessment of biological indicators (such as viral loads) as done in this study [14] can improve the interpretation of adherence reports generated by using the monitor.…”

Section: Discussionmentioning

confidence: 99%

“…Complete study details are published elsewhere [14]. Briefly, a total of 63 study participants were enrolled and followed for nine months.…”

Section: Study Proceduresmentioning

confidence: 99%

“…Qualitative interviews with study participants were conducted after Month 3 (41 interviews-known as interview 1) and after the first 48-hour lapse (30 interviews-known as interview 2), or at study exit if there was no such lapse (30 interviews--also known as interview 2), making an overall total of 101 interviews. Interviews with a purposeful sample of 10 social supporters were elsewhere [14,18,19].…”

Section: Data Collectionmentioning

confidence: 99%

“…As described previously [14], of 195 screened individuals, 63 were enrolled in the study. One participant was later discovered to be HIV negative and was excluded from the analysis.…”

Section: Participant Characteristicsmentioning

confidence: 99%

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Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial (Preprint)

Musiimenta¹,

Atukunda²,

Tumuhimbise³

et al. 2017

Preprint

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BACKGROUND Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. OBJECTIVE The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda. METHODS Individuals living with HIV who were initiating ART were enrolled in a pilot randomized controlled trial and followed up for 9 months. Participants received a real-time adherence monitor and were randomized to one of the following study arms: (1) scheduled SMS, (2) SMS triggered by missed or delayed doses, or (3) no SMS. SMS notifications were also sent to 45 patient-identified social supporters for sustained adherence lapses in the scheduled SMS and triggered SMS arms. Study participants and social supporters participated in qualitative semistructured in-depth interviews on acceptability and feasibility of this technology. An inductive, content analytic approach, framed by the unified theory of acceptance and use of technology model, was used to analyze qualitative data. Quantitative feasibility data, including device functionality and SMS tracking data, were recorded based upon device metrics collected electronically and summarized descriptively. RESULTS A total of 63 participants participated in the study. Participants reported that real-time monitoring intervention linked to SMS reminders and notifications are generally acceptable; the predominant feedback was perceived utility—the intervention was beneficial in motivating and reminding patients to take medication, as well as enabling provision of social support. The intervention was found to be technically feasible, as data were obtained from most participants as expected most of the time. Potential challenges included the impact of the technology on confidentiality, shared phone ownership, usability skills, and availability of electricity. CONCLUSIONS Real-time adherence monitoring integrated with SMS reminders and social support notifications is a generally acceptable (based primarily on perceived utility) and feasible intervention in a resource-limited country. Future efforts should focus on optimized device design, user training to overcome the challenges we encountered, cost effectiveness studies, as well as studying the monitoring aspect of the device without accompanying interventions. CLINICALTRIAL ClinicalTrials.gov NCT01957865; https://clinicaltrials.gov/ct2/show/NCT01957865 (Archived by WebCite at http://www.webcitation.org/6zFiDlXDa)

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Section: Discussionmentioning

confidence: 99%

“…Complete study details are published elsewhere [14]. Briefly, a total of 63 study participants were enrolled and followed for nine months.…”

Section: Study Proceduresmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

“…As described previously [14], of 195 screened individuals, 63 were enrolled in the study. One participant was later discovered to be HIV negative and was excluded from the analysis.…”

Section: Participant Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial (Preprint)

Musiimenta¹,

Atukunda²,

Tumuhimbise³

et al. 2017

Preprint

Self Cite

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“…The concurrent emergence of low-cost, easy-to-use mobile health (mHealth) applications like telephone-based short-messaging services (SMS) and chat applications like WhatsApp have facilitated a variety of new interventions to enhance communication between patients and health-care providers. While communicating health information via mobile phones seems to be acceptable [3][4][5], mHealth studies have reported varying levels of success at improving patient wellbeing and clinical outcomes [6][7][8][9][10][11][12][13]. Potential explanations for this variability may arise from a failure to plan for, collect, or report key process measures important for characterizing the implementation of mHealth interventions.…”

Section: Introductionmentioning

confidence: 99%

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Gupta¹,

Babirye²,

Armstrong-Hough³

et al. 2018

Preprint

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Targeted client communication via mobile devices for improving maternal, neonatal, and child health

Palmer

Villanueva

Maayan

et al. 2020

Cochrane Database of Systematic Reviews

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Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda

Cited by 145 publications

References 17 publications

Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial (Preprint)

Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial (Preprint)

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Targeted client communication via mobile devices for improving maternal, neonatal, and child health

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