Belzer Marvin E, Kolmodin MacDonell Karen, Clark Leslie F, Huang Jennifer, Olson Johanna, Kahana Shoshana Y, Naar Sylvie, Sarr Moussa, Thornton Sarah
1Department of Pediatrics, Children's Hospital Los Angeles and University of Southern California, Los Angeles, California.
2Pediatric Prevention Center, Wayne State University, Detroit, Michigan.
AIDS Patient Care STDS. 2015 Jun;29(6):338-45. doi: 10.1089/apc.2014.0282. Epub 2015 Apr 30.
A pilot randomized clinical trial of youth ages 15-24 nonadherent to antiretroviral therapy (ART) utilizing daily cell phone support was found to have significant improvement in self-reported adherence and HIV RNA. Understanding acceptability and feasibility is critical for future implementation in clinic settings. Exit interviews were obtained from participants and adherence facilitators (AF). Acceptability was assessed from content analysis of exit interviews. Feasibility was assessed via intervention retention and study retention rates. Thirty-seven eligible youth were enrolled with 19 assigned to the intervention. Seven (37%) discontinued the intervention either due to missing over 20% of calls for two consecutive months (N=5) or missing 10 consecutive calls (N=2). Sixteen participants completed exit interviews, 15 reported the call length was just right, 13 reported they would have liked to continue calls after the 24-week intervention, and all participants reported they would recommend the intervention to friends. Scheduling and making calls required less than 1 h per week per participant. Providing cell phone support to youth nonadherent to ART was acceptable and feasible. While the cost is low compared to the price of ART, healthcare systems will need to explore how to cover the cost of providing cell phones (incentive).
一项针对15至24岁未坚持抗逆转录病毒疗法(ART)的青少年的试点随机临床试验发现,利用每日手机支持可使自我报告的依从性和HIV RNA水平有显著改善。了解可接受性和可行性对于未来在临床环境中的实施至关重要。对参与者和依从性促进者(AF)进行了退出访谈。通过对退出访谈的内容分析来评估可接受性。通过干预保留率和研究保留率来评估可行性。37名符合条件的青少年被纳入研究,其中19人被分配到干预组。7人(37%)因连续两个月错过超过20%的电话(N = 5)或连续错过10个电话(N = 2)而停止了干预。16名参与者完成了退出访谈,15人报告通话时长恰到好处,13人报告他们希望在24周干预结束后继续通话,所有参与者都表示会向朋友推荐该干预措施。安排和拨打电话每位参与者每周所需时间不到1小时。为未坚持ART治疗的青少年提供手机支持是可以接受且可行的。虽然与ART的价格相比成本较低,但医疗系统需要探索如何支付提供手机的费用(激励措施)。