Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
VillageCare, New York, NY, USA.
HIV Res Clin Pract. 2020 Oct;21(5):140-150. doi: 10.1080/25787489.2020.1862972. Epub 2020 Dec 28.
Mobile health (mHealth) interventions that are integrated in HIV clinical settings to facilitate ongoing patient-provider communication between primary care visits are garnering evidence for their potential in improving HIV outcomes. Rango is an mHealth intervention to support engagement in HIV care and treatment adherence. This study used a single-arm prospective design with baseline and 6-month assessments for pre-post comparisons, as well as a matched patient sample for between-group comparisons to test Rango's preliminary efficacy in increasing viral suppression. The Rango sample (n = 406) was predominantly 50 years of age or older (63%; M = 50.67; SD = 10.97, 23-82), Black/African-American (44%) or Hispanic/Latinx (38%), and male (59%). At baseline, 18% reported missing at least one dose of ART in the prior three days and chart reviews of recent VL showed that nearly 82% of participants were virally suppressed. Overall 95% of the patients enrolled in Rango returned for a medical follow-up visit. Of the 65 unsuppressed patients at baseline who returned for a medical visit, 38 (59%) achieved viral suppression and only 5% of the suppressed group at baseline had an increase in viral load at 6 months despite being at risk for ART non-adherence. While viral suppression was similar between Rango participants and patients receiving treatment as usual over the same time period, it is unknown whether those patients were similarly at risk for non-adherence. Our findings support efforts to formally test this innovative approach in addressing ART non-adherence and viral suppression particularly to reach HIV treatment goals.
移动医疗(mHealth)干预措施已整合到 HIV 临床环境中,以促进初级保健就诊期间持续的医患沟通,这些措施正在为改善 HIV 结局提供证据。Rango 是一种支持参与 HIV 护理和治疗依从性的 mHealth 干预措施。本研究采用单臂前瞻性设计,在基线和 6 个月时进行评估,以进行前后比较,同时还对匹配的患者样本进行组间比较,以测试 Rango 在增加病毒抑制方面的初步疗效。Rango 样本(n=406)主要为 50 岁或以上(63%;M=50.67;SD=10.97,23-82),黑人和/或非裔美国人(44%)或西班牙裔/拉丁裔(38%),男性(59%)。基线时,18%的人报告在过去三天内至少漏服一剂 ART,最近的 VL 图表审查显示,近 82%的参与者病毒得到抑制。总体而言,95%参加 Rango 的患者返回进行医疗随访。在基线时未得到抑制的 65 名患者中,有 38 名(59%)达到了病毒抑制,而在基线时得到抑制的组中只有 5%的人在 6 个月时病毒载量增加,尽管他们有 ART 不依从的风险。虽然在同一时间段内,Rango 参与者和接受常规治疗的患者的病毒抑制率相似,但尚不清楚这些患者是否有类似的不依从风险。我们的研究结果支持努力正式测试这种创新方法在解决 ART 不依从和病毒抑制方面的效果,特别是为了实现 HIV 治疗目标。
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