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Authors Ruan Y, Xiao X, Chen J, Li X, Williams AB, Wang H
Received 10 September 2016
Accepted for publication 4 November 2016
Published 10 February 2017 Volume 2017:11 Pages 221—228
DOI https://doi.org/10.2147/PPA.S120003
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Dr Naifeng Liu
Aim: The aim
of this study was to examine the acceptability and efficacy of interactive
short message service (SMS) in improving medication adherence in antiretroviral
treatment (ART)-naïve individuals living with HIV/AIDS in Hengyang, Hunan,
China.
Background: SMS via mobile phone has emerged as a potential tool
for improving ART adherence. However, most studies used SMS only as a medication
reminder, with few studies exploring the effect of comprehensive, interactive
SMS.
Patients and methods: In a randomized controlled trial, 100 HIV-positive
patients on ART for <3 months were randomized into control or
intervention arm. Participants in the control group received routine standard
instruction for ART medication in the HIV clinics, while the intervention group
received 6 months of an SMS intervention in addition to the standard care.
A total of 124 text messages within 6 modules were edited, preinstalled, and
sent to participants according to personalized schedules. Knowledge (of HIV and
HIV medications), self-reported antiretroviral adherence (Visual Analog Scale
[VAS] and Community Programs for Clinical Research on AIDS [CPCRA] Antiretroviral
Medication Self-Report), and CD4 count were assessed at baseline and immediate
post-intervention. Intervention participants were interviewed after completion
of the study about their satisfaction with and acceptability of the SMS
intervention.
Results: Baseline assessments were comparable between arms.
Repeated-measures analysis showed that both HIV-related and ART medication
knowledge of the intervention group showed better improvement over time than
those of the control group after the intervention (P <0.0001).
For the adherence measures, compared with the control group, participants in
the intervention group had significantly higher VAS mean score (Z =2.735, P =0.006) and lower suboptimal
adherence rate (Z =2.208, P =0.027) at the end
of the study. The intervention had no effect on CD4 cell count. Almost all
(96%) intervention participants reported satisfaction or high satisfaction with
the SMS intervention, with 74% desiring to continue to receive the SMS
intervention. The preferred frequency of messages was 1–2 messages per week.
Conclusion: An interactive SMS intervention with comprehensive
content shows promising efficacy in promoting medication adherence in ART-naïve
individuals. Future work might further refine its ability to optimally tailor the
intervention for individual preferences.
Keywords: HIV, short message service,
antiretroviral treatment, adherence, China