School of International and Public Affairs, Columbia University, New York, New York, USA.
AIDS. 2011 Mar 27;25(6):825-34. doi: 10.1097/QAD.0b013e32834380c1.
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.
A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up.
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.
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).
These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings.
在撒哈拉以南非洲，手机普及度的增长能否被用于促进抗逆转录病毒疗法（ART）的高依从性，这方面的证据有限。本研究旨在测试短信息服务（SMS）提醒对肯尼亚农村诊所接受治疗的患者依从性的影响。
一项为期 48 周的随机对照试验，共涉及四种 SMS 提醒干预措施。
纳入了 431 名在 3 个月内开始接受 ART 的成年患者，并将其随机分配到对照组或四个干预组之一。干预组的参与者会收到短或长的 SMS 提醒，每天或每周发送一次。通过药物事件监测系统来衡量依从性。主要结果是分析的每 12 周期间和 48 周研究期间是否有超过 90%的依从率。次要结果是是否存在至少 48 小时的治疗中断。
在意向治疗分析中，接受每周 SMS 提醒的参与者中有 53%在 48 周的研究期间达到了至少 90%的依从率，而对照组中只有 40%的参与者达到了这一比例（P=0.03）。在 48 周的随访期间，接受每周提醒的组的参与者发生超过 48 小时的治疗中断的可能性也明显低于对照组（81 例比 90%，P=0.03）。
这些结果表明，SMS 提醒可能是在资源有限的环境中实现最佳治疗反应的重要工具。
