Jong SoSon, Cuca Yvette, Thompson Lisa M
School of Nursing, University of California, San Francisco.
School of Nursing, Global Health Sciences, University of California, San Francisco.
J Mob Technol Med. 2017;6(1):5-18. doi: 10.7309/jmtm.6.1.2.
This research aims to systematically review the current clinical evidence of the efficacy of mobile phone reminders on retention to care among HIV patients. This study also seeks to determine an effect size of the intervention and presents implications for future studies.
Use of mobile technologies is an innovative and affordable approach to HIV prevention and care, particularly in resource limited settings. Approximately two-thirds of people who are initially diagnosed with HIV are lost to follow-up before starting HIV treatment in low and middle-income countries, posing serious global health concerns. While mobile text message reminders for HIV medication adherence have shown positive health outcomes, it is not well understood whether the reminders can also improve patients' retention to care.
The authors conducted a meta-analysis of literature in the following databases: PubMed, CINAHL, ProQuest, and Web of Science. Of the 667 peer-reviewed research articles reviewed, nine studies were included in the final analysis. Stata version 13 was used for the analysis.
Nine studies (5 randomized controlled and 4 before and after studies) from 7 countries included 3,004 HIV patients. Random-effect meta-analysis (I-squared = 94.1%) found that HIV patients who received mobile phone reminders for their follow-up appointments were two times more likely to return to care than those who didn't receive reminders (pooled odd ratio (OR)=2.04, 95% CI: 0.97-4.27). Our sub-group analysis of 5 randomized controlled studies showed a significant effect of mobile phone reminders (OR=2.04, 95% CI: 1.11-3.74). Six studies in Africa showed that HIV patients (mostly women) receiving mobile phone reminders were three times more likely to return to care than those who received no reminders (OR=2.92, 95% CI: 1.13-7.53).
Mobile phone reminders are an effective intervention to improve retention to HIV care. Women with HIV living in resource limited settings benefit significantly from the intervention. Also, mobile phone reminders using text messages are as effective as phone calls to improve retention to HIV care.
本研究旨在系统回顾手机提醒对HIV患者坚持治疗效果的当前临床证据。本研究还试图确定该干预措施的效应大小，并为未来研究提供启示。
使用移动技术是一种创新且经济实惠的HIV预防和治疗方法，特别是在资源有限的环境中。在低收入和中等收入国家，约三分之二最初被诊断为HIV的人在开始接受HIV治疗前失访，这引发了严重的全球健康问题。虽然手机短信提醒对HIV药物依从性已显示出积极的健康结果，但对于这些提醒是否也能提高患者坚持治疗的情况尚不清楚。
作者对以下数据库中的文献进行了荟萃分析：PubMed、CINAHL、ProQuest和Web of Science。在审查的667篇同行评审研究文章中，最终分析纳入了9项研究。使用Stata 13版本进行分析。
来自7个国家的9项研究（5项随机对照研究和4项前后对照研究）纳入了3004名HIV患者。随机效应荟萃分析（I² = 94.1%）发现，收到手机随访提醒的HIV患者返回治疗的可能性是未收到提醒患者的两倍（合并比值比（OR）= 2.04，95%置信区间：0.97 - 4.27）。我们对5项随机对照研究的亚组分析显示手机提醒有显著效果（OR = 2.04，95%置信区间：1.11 - 3.74）。非洲的6项研究表明，收到手机提醒的HIV患者（大多数为女性）返回治疗的可能性是未收到提醒患者的三倍（OR = 2.92，95%置信区间：1.13 - 7.53）。
手机提醒是提高HIV治疗坚持率的有效干预措施。生活在资源有限环境中的HIV女性从该干预措施中获益显著。此外，使用短信的手机提醒在提高HIV治疗坚持率方面与电话提醒同样有效。
