Massachusetts General Hospital Center for Global Health, Boston, MA, USA.
AIDS Behav. 2010 Dec;14(6):1340-6. doi: 10.1007/s10461-010-9799-4.
Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and self-report were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.
目前的依从性评估方法通常在错过剂量很久之后才会发现。实时、无线的抗逆转录病毒治疗监测策略可能为主动预防病毒学反弹和治疗失败提供新的机会。Wisepill 是一种无线药盒，打开时会发送蜂窝信号，在 10 名乌干达个体中进行了为期 6 个月的试点测试。Wisepill、未经宣布的药片计数和自我报告测量的依从水平相互进行了比较，与之前的标准电子监测和 HIV RNA 进行了比较。Wisepill 数据最初受到电池寿命和信号传输中断的限制。在设备改进后，通过 Wisepill 实现了连续数据，中位（四分位距）依从率为 93%（87-97%），未经宣布的药片计数为 100%（99-100%），自我报告为 100%（100-100%），之前的标准电子监测为 92%（79-98%）。有 4 人出现短暂的低水平病毒血症。在克服了技术挑战之后，实时依从性监测在资源有限的环境中是可行的，并且可以在病毒反弹之前检测到不适当的依从性。
