Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: A randomized controlled trial of text message reminders

Cristian Pop-Eleches, Harsha Thirumurthy, James P. Habyarimana, Joshua G. Zivin, Markus P. Goldstein, Damien De Walque, Leslie MacKeen, Jessica Haberer, Sylvester Kimaiyo, John Sidle, Duncan Ngare, David R. Bangsberg

Research output: Contribution to journalArticle

547 Citations (Scopus)

Abstract

OBJECTIVE: There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. DESIGN: A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. METHODS: Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90% during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. RESULTS: In intention-to-treat analysis, 53% of participants receiving weekly SMS reminders achieved adherence of at least 90% during the 48 weeks of the study, compared with 40% of participants in the control group (P = 0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90%, P = 0.03). CONCLUSION: These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.

Original languageEnglish
Pages (from-to)825-834
Number of pages10
JournalAIDS
Volume25
Issue number6
DOIs
StatePublished - Mar 27 2011

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Text Messaging
Cell Phones
Randomized Controlled Trials
Technology
Control Groups
Therapeutics
Intention to Treat Analysis
Africa South of the Sahara
Kenya
Demography

Keywords

  • adherence
  • antiretroviral therapy
  • HIV/AIDS
  • mobile phones
  • randomized controlled trial
  • sub-Saharan Africa
  • text message reminders

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Pop-Eleches, C., Thirumurthy, H., Habyarimana, J. P., Zivin, J. G., Goldstein, M. P., De Walque, D., ... Bangsberg, D. R. (2011). Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: A randomized controlled trial of text message reminders. AIDS, 25(6), 825-834. https://doi.org/10.1097/QAD.0b013e32834380c1

Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting : A randomized controlled trial of text message reminders. / Pop-Eleches, Cristian; Thirumurthy, Harsha; Habyarimana, James P.; Zivin, Joshua G.; Goldstein, Markus P.; De Walque, Damien; MacKeen, Leslie; Haberer, Jessica; Kimaiyo, Sylvester; Sidle, John; Ngare, Duncan; Bangsberg, David R.

In: AIDS, Vol. 25, No. 6, 27.03.2011, p. 825-834.

Research output: Contribution to journalArticle

Pop-Eleches, C, Thirumurthy, H, Habyarimana, JP, Zivin, JG, Goldstein, MP, De Walque, D, MacKeen, L, Haberer, J, Kimaiyo, S, Sidle, J, Ngare, D & Bangsberg, DR 2011, 'Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: A randomized controlled trial of text message reminders', AIDS, vol. 25, no. 6, pp. 825-834. https://doi.org/10.1097/QAD.0b013e32834380c1
Pop-Eleches, Cristian ; Thirumurthy, Harsha ; Habyarimana, James P. ; Zivin, Joshua G. ; Goldstein, Markus P. ; De Walque, Damien ; MacKeen, Leslie ; Haberer, Jessica ; Kimaiyo, Sylvester ; Sidle, John ; Ngare, Duncan ; Bangsberg, David R. / Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting : A randomized controlled trial of text message reminders. In: AIDS. 2011 ; Vol. 25, No. 6. pp. 825-834.
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abstract = "OBJECTIVE: There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. DESIGN: A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. METHODS: Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90{\%} during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. RESULTS: In intention-to-treat analysis, 53{\%} of participants receiving weekly SMS reminders achieved adherence of at least 90{\%} during the 48 weeks of the study, compared with 40{\%} of participants in the control group (P = 0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90{\%}, P = 0.03). CONCLUSION: These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.",
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AU - Sidle, John

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AB - OBJECTIVE: There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya. DESIGN: A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up. METHODS: Four hundred and thirty-one adult patients who had initiated ART within 3 months were enrolled and randomly assigned to a control group or one of the four intervention groups. Participants in the intervention groups received SMS reminders that were either short or long and sent at a daily or weekly frequency. Adherence was measured using the medication event monitoring system. The primary outcome was whether adherence exceeded 90% during each 12-week period of analysis and the 48-week study period. The secondary outcome was whether there were treatment interruptions lasting at least 48 h. RESULTS: In intention-to-treat analysis, 53% of participants receiving weekly SMS reminders achieved adherence of at least 90% during the 48 weeks of the study, compared with 40% of participants in the control group (P = 0.03). Participants in groups receiving weekly reminders were also significantly less likely to experience treatment interruptions exceeding 48 h during the 48-week follow-up period than participants in the control group (81 vs. 90%, P = 0.03). CONCLUSION: These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.

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