Real-time Medication Adherence Monitoring Intervention: Test of Concept in People Living With HIV Infection
Real-time Medication Adherence Monitoring Intervention: Test of Concept in People Living With HIV Infection
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DOI：
10.1016/j.jana.2014.06.002
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发表时间：
2014-11-01
影响因子：
2
通讯作者：
Kalichman, Moira O.
中科院分区：
文献类型：
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作者：
Pellowski, Jennifer A.;Kalichman, Seth C.;Kalichman, Moira O.
Wisepill设备(南非萨默塞特郡西部的Wisepill Technologies)是一种新兴的移动医疗技术，可能会增强艾滋病毒携带者对抗逆转录病毒疗法(ART)的坚持。Wisepill是一种电子弹药箱，最多可容纳30粒大药丸或60粒小药丸。打开Wisepill向基于Web的服务器发送蜂窝信号，临床医生可以实时访问该服务器以进行监测，并可能触发干预。此前的研究重点是在各种环境下使用Wisepill设备进行患者监护的可行性和可接受性。在乌干达，患者描述该设备易于使用和方便，研究人员发现，Wisepill产生的结果类似于药物事件监测系统药瓶盖(Haberer等人，2010年)。然而，在中国，另一组研究人员发现，尽管使用Wisepill进行实时药物监测在技术上是可行的，但患者对该设备的接受性存在担忧(Bachman DeSilva等人，2013年)。只有一半的参与者报告了积极的经历。到目前为止，还没有研究过美国的Wisepill，因为在美国，艾滋病毒感染集中在临床资源有限的贫困地区(Pellowski，Kalichman，Matthews，&Adler，2013)。除了药物监测之外，Wisepill还提供了“及时”咨询的机会(Haberer等人，2010年)。当个人没有在规定的药物剂量时间内打开Wisepill时，依从性服务提供商有机会联系患者，提示他/她服用该剂量并解决即时障碍。然而，据我们所知，还没有研究测试使用Wisepill设备启动即时咨询作为提高依从性的干预措施的可行性。我们研究的目的是确定使用Wisepill向接受HIV治疗的个人提供及时依从性干预的可行性、可接受性和潜在疗效。
The Wisepill device (Wisepill Technologies, Somerset West, South Africa) is an emerging mobile health technology that may enhance antiretroviral therapy (ART) adherence among people living with HIV. The Wisepill is an electronic pillbox that holds up to 30 large pills or 60 small pills. Opening the Wisepill sends a cellular signal to a Web-based server that can be accessed in real time by clinicians for monitoring purposes and to potentially trigger intervention. Previous studies have focused on the feasibility and acceptability of using the Wisepill device for patient monitoring in various settings. In Uganda, patients described the device as easy to use and convenient, and the researchers found that the Wisepill produced results similar to medication event monitoring systems pill bottle caps (Haberer et al., 2010). In China, however, another group of researchers found that although using the Wisepill for real-time medication monitoring was technically feasible, there were concerns regarding the acceptability of the device to patients (Bachman DeSilva et al., 2013). Only half of all participants reported positive experiences. No studies to date have examined the Wisepill in the United States, where HIV infections are concentrated in impoverished areas with limited clinical resources (Pellowski, Kalichman, Matthews, & Adler, 2013). In addition to medication monitoring, the Wisepill affords the opportunity for ‘‘just-in-time’’counseling (Haberer et al., 2010). When an individual does not open the Wisepill at the prescribed medication dose time, adherence service providers have the opportunity to contact the patient to prompt him/her to take the dose and resolve in-the-moment barriers. However, to our knowledge, no studies have tested the feasibility of using the Wisepill device to initiate just-in-time counseling as an intervention to improve adherence. The purpose of our study was to determine the feasibility, acceptability, and potential efficacy of using the Wisepill to deliver a just-in-time adherence intervention to individuals receiving HIV treatment.