University of Connecticut, Storrs, Connecticut 06269, USA.
AIDS Patient Care STDS. 2011 May;25(5):303-10. doi: 10.1089/apc.2010.0367. Epub 2011 Apr 2.
Affordable and effective antiretroviral therapy (ART) adherence interventions are needed for many patients to promote positive treatment outcomes and prevent viral resistance. We conducted a two-arm randomized trial (n = 40 men and women receiving and less than 95% adherent to ART) to test a single office session followed by four biweekly cell phone counseling sessions that were grounded in behavioral self-management model of medication adherence using data from phone-based unannounced pill counts to provide feedback-guided adherence strategies. The control condition received usual care and matched office and cell phone/pill count contacts. Participants were baseline assessed and followed with biweekly unannounced pill counts and 4-month from baseline computerized interviews (39/40 retained). Results showed that the self-regulation counseling delivered by cell phone demonstrated significant improvements in adherence compared to the control condition; adherence improved from 87% of pills taken at baseline to 94% adherence 4 months after baseline, p < 0.01. The observed effect sizes ranged from moderate (d = 0.45) to large (d = 0.80). Gains in adherence were paralleled with increased self-efficacy (p < 0.05) and use of behavioral strategies for ART adherence (p < 0.05). We conclude that the outcomes from this test of concept trial warrant further research on cell phone-delivered self-regulation counseling in a larger and more rigorous trial.
需要提供负担得起且有效的抗逆转录病毒疗法 (ART) 依从性干预措施，以促进许多患者的积极治疗结果并预防病毒耐药性。我们进行了一项两臂随机试验（n=40 名接受和低于 95%依从性的 ART 的男性和女性），以测试单次办公室会议后进行的四项双周手机咨询，这些咨询基于行为自我管理模型药物依从性，使用基于电话的未宣布药丸计数提供反馈指导的依从性策略。对照组接受常规护理，并与办公室和手机/药丸计数联系相匹配。参与者在基线进行评估，并在基线后每两周进行一次未宣布的药丸计数和 4 个月的计算机访谈（保留 39/40 人）。结果表明，与对照组相比，通过手机提供的自我调节咨询在依从性方面有显著改善；依从性从基线时的 87%提高到基线后 4 个月时的 94%，p<0.01。观察到的效果大小从中度（d=0.45）到较大（d=0.80）不等。依从性的提高与自我效能的提高（p<0.05）和使用行为策略来提高 ART 依从性（p<0.05）相平行。我们得出结论，该概念验证试验的结果证明，在更大和更严格的试验中，基于手机的自我调节咨询值得进一步研究。
