Ruan Ye, Xiao Xueling, Chen Jia, Li Xianhong, Williams Ann Bartley, Wang Honghong
Nursing Department, Second Xiangya Hospital.
Xiangya School of Nursing, Central South University, Changsha, Hunan, People's Republic of China.
Patient Prefer Adherence. 2017 Feb 10;11:221-228. doi: 10.2147/PPA.S120003. eCollection 2017.
The aim of this study was to examine the acceptability and efficacy of interactive short message service (SMS) in improving medication adherence in antiretroviral treatment (ART)-naïve individuals living with HIV/AIDS in Hengyang, Hunan, China.
SMS via mobile phone has emerged as a potential tool for improving ART adherence. However, most studies used SMS only as a medication reminder, with few studies exploring the effect of comprehensive, interactive SMS.
In a randomized controlled trial, 100 HIV-positive patients on ART for <3 months were randomized into control or intervention arm. Participants in the control group received routine standard instruction for ART medication in the HIV clinics, while the intervention group received 6 months of an SMS intervention in addition to the standard care. A total of 124 text messages within 6 modules were edited, preinstalled, and sent to participants according to personalized schedules. Knowledge (of HIV and HIV medications), self-reported antiretroviral adherence (Visual Analog Scale [VAS] and Community Programs for Clinical Research on AIDS [CPCRA] Antiretroviral Medication Self-Report), and CD4 count were assessed at baseline and immediate post-intervention. Intervention participants were interviewed after completion of the study about their satisfaction with and acceptability of the SMS intervention.
Baseline assessments were comparable between arms. Repeated-measures analysis showed that both HIV-related and ART medication knowledge of the intervention group showed better improvement over time than those of the control group after the intervention (<0.0001). For the adherence measures, compared with the control group, participants in the intervention group had significantly higher VAS mean score (=2.735, =0.006) and lower suboptimal adherence rate (=2.208, =0.027) at the end of the study. The intervention had no effect on CD4 cell count. Almost all (96%) intervention participants reported satisfaction or high satisfaction with the SMS intervention, with 74% desiring to continue to receive the SMS intervention. The preferred frequency of messages was 1-2 messages per week.
An interactive SMS intervention with comprehensive content shows promising efficacy in promoting medication adherence in ART-naïve individuals. Future work might further refine its ability to optimally tailor the intervention for individual preferences.
本研究旨在探讨交互式短信服务（SMS）在中国湖南衡阳未接受过抗逆转录病毒治疗（ART）的HIV/AIDS感染者中提高用药依从性的可接受性和有效性。
通过手机发送的短信已成为提高ART依从性的一种潜在工具。然而，大多数研究仅将短信用作用药提醒，很少有研究探讨全面、交互式短信的效果。
在一项随机对照试验中，100名接受ART治疗时间<3个月的HIV阳性患者被随机分为对照组或干预组。对照组参与者在HIV诊所接受ART药物治疗的常规标准指导，而干预组除接受标准护理外，还接受为期6个月的短信干预。根据个性化时间表编辑、预装并向参与者发送了6个模块中的总共124条短信。在基线和干预后即刻评估（对HIV和HIV药物的）知识、自我报告的抗逆转录病毒依从性（视觉模拟量表[VAS]和艾滋病临床研究社区项目[CPCRA]抗逆转录病毒药物自我报告）以及CD4细胞计数）。在研究结束后，对干预组参与者进行访谈，了解他们对短信干预的满意度和可接受性。
两组的基线评估具有可比性。重复测量分析表明，干预后，干预组的HIV相关知识和ART药物知识随时间的改善均优于对照组（<0.0001）。对于依从性测量，与对照组相比，干预组参与者在研究结束时的VAS平均得分显著更高（=2.735，=0.006），次优依从率更低（=2.208，=0.027）。干预对CD4细胞计数没有影响。几乎所有（96%）干预组参与者对短信干预表示满意或高度满意，74%的人希望继续接收短信干预。首选的短信发送频率是每周1 - 2条。
具有全面内容的交互式短信干预在促进未接受过ART治疗的个体的用药依从性方面显示出有前景的效果。未来的工作可能会进一步优化其根据个体偏好量身定制干预措施的能力。
