Satyanarayana Veena A, Duggal Mona, Jeon Sangchoon, Singh Pushpendra, Desai Anita, Chandra Prabha S, Reynolds Nancy R
National Institute of Mental Health and Neuro Sciences, Bengaluru, 560029, India.
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Arch Womens Ment Health. 2024 Oct;27(5):751-763. doi: 10.1007/s00737-024-01462-0. Epub 2024 Apr 17.
We evaluated the feasibility, acceptability and preliminary efficacy of a standardized nurse delivered mobile phone intervention to improve adherence to antiretroviral treatment and clinical outcomes.
Feasibility and acceptability of the phone intervention was assessed with rates of eligibility, completed visits, and attritions. Intervention fidelity was assessed by checking recorded calls and feedback. Efficacy was assessed using a randomized controlled trial in which 120 women living with HIV and psychosocial vulnerabilities, were randomized to Treatment as Usual (TAU = 60) or TAU plus the mobile phone intervention (N = 60). Trained basic nurses delivered the theory-guided, standardized mobile phone intervention for mental health issues and psychosocial risk factors to improve antiretroviral treatment (ART) adherence and retention in care and improve clinical outcomes. Blind raters performed the assessments at 6, 12 and 24 weeks post-randomization.
Adherence diminished over time in the TAU only group, while it was sustained in the TAU Plus group, only dropping at 24 weeks after the intervention had been discontinued. Among participants with depressive symptoms (CESD ≥ 16), the intervention had significant improvement in adherence rates (p < 0.01), psychological quality of life (p < 0.05) and illness perception (p < 0.05) compared to those in the TAU only group. Greater improvements of quality of life subscales were observed in the TAU Plus group among participants with less psychological vulnerability (PSV < 2). HIV RNA was not significantly different between the groups at week 24.
The mobile-delivered counseling intervention was feasible and acceptable and shows promise among women living with HIV and psychosocial vulnerabilities in rural South India.
ClinicalTrials.gov Identifier: NCT02319330 [Registered on: December 18, 2014].
我们评估了由护士提供的标准化手机干预措施在改善抗逆转录病毒治疗依从性及临床结局方面的可行性、可接受性和初步疗效。
通过符合条件的比例、完成访视的比例和失访率来评估手机干预措施的可行性和可接受性。通过检查录音通话和反馈来评估干预的保真度。采用随机对照试验评估疗效，将120名感染艾滋病毒且存在心理社会脆弱性的女性随机分为常规治疗组（TAU，n = 60）或常规治疗加手机干预组（n = 60）。经过培训的基层护士针对心理健康问题和心理社会风险因素实施理论指导的标准化手机干预措施，以提高抗逆转录病毒治疗（ART）的依从性、维持治疗率并改善临床结局。在随机分组后的6周、12周和24周，由盲法评估人员进行评估。
仅接受常规治疗的组中，依从性随时间下降，而常规治疗加手机干预组的依从性得以维持，仅在干预停止后的24周有所下降。在有抑郁症状（CESD≥16）的参与者中，与仅接受常规治疗的组相比，干预措施在依从率（p<0.01）、心理生活质量（p<0.05）和疾病认知（p<0.05）方面有显著改善。在心理脆弱性较低（PSV<2）的参与者中，常规治疗加手机干预组在生活质量子量表方面有更大改善。24周时，两组之间的HIV RNA水平无显著差异。
通过手机提供的咨询干预措施是可行且可接受的，在印度南部农村地区感染艾滋病毒且存在心理社会脆弱性的女性中显示出前景。
ClinicalTrials.gov标识符：NCT02319330 [注册日期：2014年12月18日]
