移动医疗干预措施促进 HIV 患者抗逆转录病毒依从性：叙事性综述。
mHealth Interventions to Promote Anti-Retroviral Adherence in HIV: Narrative Review.
机构信息
Department of Medicine, Division of Infectious Diseases, University of Saskatchewan College of Medicine, Regina, SK, Canada.
Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, United States.
出版信息
JMIR Mhealth Uhealth. 2020 Aug 28;8(8):e14739. doi: 10.2196/14739.
BACKGROUND
Antiretrovirals (ARVs) are key in the management of HIV. Although no cure exists, ARVs help patients live healthy lives and prevent transmission to others. Adherence to complex regimens is paramount to outcomes and in avoiding the emergence of drug-resistant viruses. The goal of therapy is to reach an undetectable viral load. However, adherence is a common problem, stemming from issues such as mental health, chaotic home situations, and busy work schedules. Mobile health (mHealth) represents a new approach in improving medication adherence, and multiple studies have been performed in this area.
OBJECTIVE
This study aims to review the current implementation of mHealth in the management of HIV among different groups of patients.
METHODS
We used PubMed, Academic Search Elite, and 1 journal database with various search terms to review the current implementation of mHealth in HIV care.
RESULTS
Titles and abstracts were screened, and 61 papers were identified and fully reviewed. The literature was divided into lower- and higher-income nations, as defined by the United Nations. A total of 20 studies with quantitative results were identified, with 10 being text- and SMS-based interventions (the majority of these being in lower-income countries) and 8 being smartphone-based apps (primarily in higher-income countries). The majority of these studies determined whether there was an effect on adherence or biochemical parameters (viral load and CD4 count). Various qualitative studies have also been conducted, and many have focused on determining the specific design of interventions that were successful (frequency of messaging, types of messages, etc) as well as priorities for patients with regard to mHealth interventions.
CONCLUSIONS
There seems to be a role of mHealth in the management of HIV in lower-income nations; however, the optimal design of an intervention needs to be delineated. In higher-income countries, where the 2 significant risk factors were injection drugs and men who have sex with men, the benefit was less clear, and more research is needed.
背景
抗逆转录病毒药物（ARV）是 HIV 管理的关键。虽然目前尚无治愈方法，但 ARV 有助于患者过上健康的生活，并防止病毒传播给他人。坚持复杂的治疗方案对于获得良好的治疗效果和避免耐药病毒的出现至关重要。治疗的目标是达到无法检测到的病毒载量。然而，坚持治疗是一个常见的问题，源于心理健康、混乱的家庭环境和繁忙的工作时间表等问题。移动医疗（mHealth）代表了改善药物依从性的一种新方法，并且已经在该领域进行了多项研究。
目的
本研究旨在综述不同患者群体中 mHealth 在 HIV 管理中的应用现状。
方法
我们使用 PubMed、Academic Search Elite 和 1 个期刊数据库，使用各种搜索词来综述 mHealth 在 HIV 护理中的应用现状。
结果
筛选标题和摘要，确定了 61 篇论文，并对其进行了全面审查。文献分为联合国定义的低收入和高收入国家。确定了总共 20 项具有定量结果的研究，其中 10 项是基于文本和短信的干预措施（其中大多数在低收入国家），8 项是基于智能手机的应用程序（主要在高收入国家）。这些研究大多旨在确定干预措施对依从性或生化参数（病毒载量和 CD4 计数）是否有影响。也进行了各种定性研究，许多研究都集中在确定成功干预措施的具体设计（消息发送频率、消息类型等）以及患者对 mHealth 干预措施的关注重点。
结论
mHealth 在低收入国家的 HIV 管理中似乎具有一定作用；然而，需要确定干预措施的最佳设计。在高收入国家，注射毒品和男男性行为者是两个主要的风险因素，其效果不太明确，需要进一步研究。
Zotero 插件