Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults
Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults
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DOI：
10.2105/ajph.2017.304089
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发表时间：
2017-12-01
影响因子：
12.7
通讯作者：
Mukasa, Barbara
中科院分区：
文献类型：
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作者：
Linnemayr, Sebastian;Huang, Haijing;Mukasa, Barbara
目标。评估短信服务 (SMS) 提醒信息对 HIV 阳性青少年坚持抗逆转录病毒和复方新诺明预防的有效性，以及有和没有回复选项的 SMS 的相对有效性。方法。乌干达坎帕拉 2 个 HIV 诊所的 15 至 22 岁符合条件的 HIV 阳性患者参加了一项为期一年的平行个体随机对照试验，并以 1:1:1 的比例被分配到每周 SMS 消息组、每周 SMS 消息响应选项组或常规护理对照组。结果。我们招募了 332 名参与者。在意向治疗分析中，电子测量的平均依从性在对照组中为 67%，在单向 SMS 组中为 64%（95% 置信区间 [CI] = 0.77, 1.14），在 2 向 SMS 组中为 61%（95% CI = 0.75, 1.12）。次要结局和完整病例分析的结果在各组中同样没有统计学意义。结论。尽管之前的证据表明使用短信提醒的干预措施可以促进抗逆转录病毒治疗的依从性，但这项研究表明它们并不总是有效地实现行为改变。需要更多的研究来找出它们对谁以及在什么条件下有益。
Objectives. To assess the effectiveness of Short Message Service (SMS) reminder messages on antiretroviral and cotrimoxazole prophylaxis adherence among HIV-positive youths as well as the relative effectiveness of SMS with and without a response option.Methods. Eligible HIV-positive patients aged 15 to 22 years at 2 HIV clinics in Kampala, Uganda, participated in a year-long parallel individual-randomized controlled trial and were assigned in a 1-to-1-to-1 ratio to a weekly SMS message group, weekly SMS message with response option group, or a usual-care control group.Results. We enrolled 332 participants. Electronically measured mean adherence was 67% in the control group, 64% in the 1-way SMS group (95% confidence interval [CI] = 0.77, 1.14), and 61% in the 2-way SMS group (95% CI = 0.75, 1.12) in an intent-to-treat analysis. Results for secondary outcomes and complete-case analysis were similarly statistically insignificant across groups.Conclusions. Despite previous evidence that interventions using SMS reminders can promote antiretroviral therapy adherence, this study shows that they are not always effective in achieving behavior change. More research is needed to find out for whom, and under what conditions, they can be beneficial.