Test of a Web-Based Program to Improve Adherence to HIV Medications

Hersch, Rebekah K.; Cook, Royer F.; Billings, Douglas W.; Kaplan, Seth A.; Murray, David M.; Safren, Steven A.; Goforth, Justin; Spencer, Joy

doi:10.1007/s10461-013-0535-8

Cited by 42 publications

(58 citation statements)

References 36 publications

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“…79 The country in which the study was conducted was not reported in five studies. [80][81][82][83][84] The median sample size was 170 (min = 34; max 966).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The effects of interventions are summarized in Table 1 46,48,54,62,64,[66][67][68]73,81 Details of the latter studies serve to illuminate the most potent interventions among the studies in this review. Chung and colleagues 66 conducted a randomized controlled factorial design trial in 361 treatment naïve HIV-infected adults in Nairobi, Kenya initiating ART.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Follow-up was for 48 weeks. 81 investigated the efficacy of a webbased programme to improve adherence to medication in people receiving ART. One hundred and sixty-eight adults were randomized to receive the web-based programme or a waitlist.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Five of the 30 (17%) studies with an explicit theoretical framework were successful in improving both adherence and clinical outcomes. 46,48,54,66,81 Effects by use of technology. Five studies used technology-based interventions (interactive computers assisted sessions, phone calls, text messaging, and pagers).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

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Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

Mbuagbaw

Sivaramalingam

Navarro

et al. 2015

AIDS Patient Care and STDs

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We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged.

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“…79 The country in which the study was conducted was not reported in five studies. [80][81][82][83][84] The median sample size was 170 (min = 34; max 966).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

Mbuagbaw

Sivaramalingam

Navarro

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

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“…Positive Health Check (PHC) is a web-based video counseling tool to reduce HIV transmission and improve health outcomes for people living with HIV (PLWH). The tool was developed based on evidence that computer-based counseling tools can reduce sexual risk behaviors and improve antiretroviral therapy (ART) adherence [1,2,[10][11][12][13] and viral load suppression [12]. PHC is grounded in the Information-BehaviorMotivation model [14], Motivational Interviewing [15], and the Transtheoretical model [16].…”

Section: Introductionmentioning

confidence: 99%

Implementing Web-Based Interventions in HIV Primary Care Clinics: Pilot Implementation Evaluation of Positive Health Check (Preprint)

Harshbarger¹,

Burrus²,

Zulkiewicz³

et al. 2018

Preprint

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Background: Web-based interventions can help people living with human immunodeficiency virus (HIV) achieve better clinical outcomes and behaviors, but integrating them into clinical practice remains challenging. Several studies report on the appropriate content for web-based interventions and their outcomes, but there is a gap in understanding the feasibility of implementing these interventions in HIV clinic settings from the clinicians' perspective. Objective: We examined whether Positive Health Check (PHC)-a web-based, tailored video counseling tool-was acceptable, appropriate, and feasible for HIV primary care clinics to implement. Methods: Four primary care clinics implemented PHC during a 1-month pilot. Nine key clinic staff across clinics who implemented the intervention participated in 54 interviews. We used framework analysis to code the data and identify themes related to implementation outcomes; acceptability, appropriateness, and feasibility. We also analyzed patients' (n=104) intervention usage metrics to quantify patients' intervention completion rates (n=68). Results: At the start of implementation, and with increasing frequency as enrollment was opened to more diverse patient groups, clinic staff reported that PHC was an acceptable and appropriate intervention. Stakeholders successfully dedicated space for patients to use the tool, delivered patients' handouts, and adjusted workflow to facilitate implementation. Clinic staff reported that PHC is feasible to implement in clinic settings, but challenges remained for workflow integration and the best time to administer PHC. Conclusions: To increase implementation effectiveness, we examined implementation outcomes related to the integration of PHC into clinic workflows. Findings from this pilot implementation suggest that PHC can be integrated into clinic workflow systems, but clinicians and researchers need to better understand the role of implementation outcomes to leverage the benefits of tailored web-based interventions for people living with HIV.

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Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review

et al. 2017

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In the United States (US), there are high levels of disengagement along the HIV care continuum. We sought to characterize the heterogeneity in research studies and interventions to improve care engagement among people living with diagnosed HIV infection. We performed a systematic literature search for interventions to improve HIV linkage to care, retention in care, reengagement in care and adherence to antiretroviral therapy (ART) in the US published from 2007-mid 2015. Study designs and outcomes were allowed to vary in included studies. We grouped interventions into categories, target populations, and whether results were significantly improved. We identified 152 studies, 7 (5%) linkage studies, 33 (22%) retention studies, 4 (3%) reengagement studies, and 117 (77%) adherence studies. ‘Linkage’ studies utilized 11 different outcome definitions, while ‘retention’ studies utilized 39, with very little consistency in effect measurements. The majority (59%) of studies reported significantly improved outcomes, but this proportion and corresponding effect sizes varied substantially across study categories. This review highlights a paucity of assessments of linkage and reengagement interventions; limited generalizability of results; and substantial heterogeneity in intervention types, outcome definitions, and effect measures. In order to make strides against the HIV epidemic in the US, care continuum research must be improved and benchmarked against an integrated, comprehensive framework.

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Test of a Web-Based Program to Improve Adherence to HIV Medications

Cited by 42 publications

References 36 publications

Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

Implementing Web-Based Interventions in HIV Primary Care Clinics: Pilot Implementation Evaluation of Positive Health Check (Preprint)

Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review

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