Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.

BACKGROUND: Adherence is central to the success of antiretroviral therapy. Supporting adherence has gained importance in HIV care in many national treatment programs. The ubiquity of mobile phones, even in resource-constrained settings, has provided an opportunity to utilize an inexpensive, contextu...

Full description

Bibliographic Details
Main Authors: Rashmi Rodrigues, Anita Shet, Jimmy Antony, Kristi Sidney, Karthika Arumugam, Shubha Krishnamurthy, George D'Souza, Ayesha DeCosta
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3428344?pdf=render
_version_ 1818041216417136640
author Rashmi Rodrigues
Anita Shet
Jimmy Antony
Kristi Sidney
Karthika Arumugam
Shubha Krishnamurthy
George D'Souza
Ayesha DeCosta
author_facet Rashmi Rodrigues
Anita Shet
Jimmy Antony
Kristi Sidney
Karthika Arumugam
Shubha Krishnamurthy
George D'Souza
Ayesha DeCosta
author_sort Rashmi Rodrigues
collection DOAJ
description BACKGROUND: Adherence is central to the success of antiretroviral therapy. Supporting adherence has gained importance in HIV care in many national treatment programs. The ubiquity of mobile phones, even in resource-constrained settings, has provided an opportunity to utilize an inexpensive, contextually feasible technology for adherence support in HIV in these settings. We aimed to assess the influence of mobile phone reminders on adherence to antiretroviral therapy in South India. Participant experiences with the intervention were also studied. This is the first report of such an intervention for antiretroviral adherence from India, a country with over 800 million mobile connections. METHODS: STUDY DESIGN: Quasi-experimental cohort study involving 150 HIV-infected individuals from Bangalore, India, who were on antiretroviral therapy between April and July 2010. The intervention: All participants received two types of adherence reminders on their mobile phones, (i) an automated interactive voice response (IVR) call and (ii) A non-interactive neutral picture short messaging service (SMS), once a week for 6 months. Adherence measured by pill count, was assessed at study recruitment and at months one, three, six, nine and twelve. Participant experiences were assessed at the end of the intervention period. RESULTS: The mean age of the participants was 38 years, 27% were female and 90% urban. Overall, 3,895 IVRs and 3,073 SMSs were sent to the participants over 6 months. Complete case analysis revealed that the proportion of participants with optimal adherence increased from 85% to 91% patients during the intervention period, an effect that was maintained 6 months after the intervention was discontinued (p = 0.016). Both, IVR calls and SMS reminders were considered non-intrusive and not a threat to privacy. A significantly higher proportion agreed that the IVR was helpful compared to the SMS (p<0.001). CONCLUSION: Mobile phone reminders may improve medication adherence in HIV infected individuals in this setting, the effect of which was found to persist for at least 6 months after cessation of the intervention.
first_indexed 2024-12-10T08:26:54Z
format Article
id doaj.art-441bace736824cd2bdda723118f3912e
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-10T08:26:54Z
publishDate 2012-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-441bace736824cd2bdda723118f3912e2022-12-22T01:56:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0178e4072310.1371/journal.pone.0040723Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.Rashmi RodriguesAnita ShetJimmy AntonyKristi SidneyKarthika ArumugamShubha KrishnamurthyGeorge D'SouzaAyesha DeCostaBACKGROUND: Adherence is central to the success of antiretroviral therapy. Supporting adherence has gained importance in HIV care in many national treatment programs. The ubiquity of mobile phones, even in resource-constrained settings, has provided an opportunity to utilize an inexpensive, contextually feasible technology for adherence support in HIV in these settings. We aimed to assess the influence of mobile phone reminders on adherence to antiretroviral therapy in South India. Participant experiences with the intervention were also studied. This is the first report of such an intervention for antiretroviral adherence from India, a country with over 800 million mobile connections. METHODS: STUDY DESIGN: Quasi-experimental cohort study involving 150 HIV-infected individuals from Bangalore, India, who were on antiretroviral therapy between April and July 2010. The intervention: All participants received two types of adherence reminders on their mobile phones, (i) an automated interactive voice response (IVR) call and (ii) A non-interactive neutral picture short messaging service (SMS), once a week for 6 months. Adherence measured by pill count, was assessed at study recruitment and at months one, three, six, nine and twelve. Participant experiences were assessed at the end of the intervention period. RESULTS: The mean age of the participants was 38 years, 27% were female and 90% urban. Overall, 3,895 IVRs and 3,073 SMSs were sent to the participants over 6 months. Complete case analysis revealed that the proportion of participants with optimal adherence increased from 85% to 91% patients during the intervention period, an effect that was maintained 6 months after the intervention was discontinued (p = 0.016). Both, IVR calls and SMS reminders were considered non-intrusive and not a threat to privacy. A significantly higher proportion agreed that the IVR was helpful compared to the SMS (p<0.001). CONCLUSION: Mobile phone reminders may improve medication adherence in HIV infected individuals in this setting, the effect of which was found to persist for at least 6 months after cessation of the intervention.http://europepmc.org/articles/PMC3428344?pdf=render
spellingShingle Rashmi Rodrigues
Anita Shet
Jimmy Antony
Kristi Sidney
Karthika Arumugam
Shubha Krishnamurthy
George D'Souza
Ayesha DeCosta
Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
PLoS ONE
title Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
title_full Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
title_fullStr Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
title_full_unstemmed Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
title_short Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India.
title_sort supporting adherence to antiretroviral therapy with mobile phone reminders results from a cohort in south india
url http://europepmc.org/articles/PMC3428344?pdf=render
work_keys_str_mv AT rashmirodrigues supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT anitashet supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT jimmyantony supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT kristisidney supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT karthikaarumugam supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT shubhakrishnamurthy supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT georgedsouza supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia
AT ayeshadecosta supportingadherencetoantiretroviraltherapywithmobilephoneremindersresultsfromacohortinsouthindia