Moore David J, Poquette Amelia, Casaletto Kaitlin B, Gouaux Ben, Montoya Jessica L, Posada Carolina, Rooney Alexandra S, Badiee Jayraan, Deutsch Reena, Letendre Scott L, Depp Colin A, Grant Igor, Atkinson J Hampton
Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, 92093, USA,
AIDS Behav. 2015 Mar;19(3):459-71. doi: 10.1007/s10461-014-0971-0.
HIV+ persons with co-occurring bipolar disorder (HIV+/BD+) have elevated rates of medication nonadherence. We conducted a 30-day randomized controlled trial of a two-way, text messaging system, iTAB (n = 25), compared to an active comparison (CTRL) (n = 25) to improve antiretroviral (ARV) and psychotropic (PSY) adherence and dose timing. Both groups received medication adherence psychoeducation and daily texts assessing mood. The iTAB group additionally received personalized medication reminder texts. Participants responded to over 90 % of the mood and adherence text messages. Mean adherence, as assessed via electronic monitoring caps, was high and comparable between groups for both ARV (iTAB 86.2 % vs. CTRL 84.8 %; p = 0.95, Cliff's d = 0.01) and PSY (iTAB 78.9 % vs. CTRL 77.3 %; p = 0.43, Cliff's d = -0.13) medications. However, iTAB participants took ARVs significantly closer to their intended dosing time than CTRL participants (iTAB: 27.8 vs. CTRL: 77.0 min from target time; p = 0.02, Cliff's d = 0.37). There was no group difference on PSY dose timing. Text messaging interventions may represent a low-burden approach to improving timeliness of medication-taking behaviors among difficult-to-treat populations. The benefits of improved dose timing for long-term medication adherence require additional investigation.
合并双相情感障碍的HIV感染者（HIV+/BD+）药物治疗依从性较差。我们进行了一项为期30天的随机对照试验，将双向短信系统iTAB（n = 25）与积极对照（CTRL）组（n = 25）进行比较，以提高抗逆转录病毒药物（ARV）和精神药物（PSY）的依从性及给药时间准确性。两组均接受了药物治疗依从性心理教育，并每天收到评估情绪的短信。iTAB组还额外收到个性化的药物提醒短信。参与者对超过90%的情绪和依从性短信进行了回复。通过电子监测帽评估，两组的ARV药物（iTAB组86.2% vs. CTRL组84.8%；p = 0.95，Cliff's d = 0.01）和PSY药物（iTAB组78.9% vs. CTRL组77.3%；p = 0.43，Cliff's d = -0.13）的平均依从性都很高且相当。然而，iTAB组参与者服用ARV药物的时间比CTRL组参与者更接近预期给药时间（iTAB组：距目标时间27.8分钟 vs. CTRL组：77.0分钟；p = 0.02，Cliff's d = 0.37）。PSY药物给药时间上两组无差异。短信干预可能是一种低负担的方法，可改善难治人群服药行为的及时性。改善给药时间对长期药物治疗依从性的益处还需要进一步研究。
