Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials.
Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials.
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DOI：
10.1371/journal.pone.0088166
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Johnson BT
中科院分区：
文献类型：
--
作者：
Finitsis DJ;Pellowski JA;Johnson BT
抗逆转录病毒疗法的疗效取决于患者是否坚持每日服药，但许多患者未能以足够高的比例坚持服药，以维持健康和降低传播艾滋病毒的风险。鉴于全球移动电话使用的爆炸性增长，短信干预以促进遵守特别合适。这项荟萃分析综合了可用的短信干预措施，以促进艾滋病毒感染者抗逆转录病毒治疗的依从性。我们进行了电子数据库的布尔搜索，手工搜索近年来的会议摘要和反向搜索。纳入的研究（1）针对HIV感染者样本的抗逆转录病毒治疗依从性，（2）使用随机对照试验设计检查短信干预，（3）报告至少一项依从性测量或临床结局。8项研究（包括9项干预措施）符合入选标准。短信干预的依从性显著高于对照组（OR = 1.39; 95%CI = 1.18，1.64）。 干预特征的敏感性分析表明，当干预措施（1）发送频率低于每日，（2）支持双向沟通，（3）包括个性化的信息内容，（4）与参与者的抗逆转录病毒治疗给药计划相匹配时，研究具有更大的效果。干预还与病毒载量和/或CD 4+计数的改善相关（k = 3; OR = 1.56; 95% CI = 1.11，2.20）。 短信可以支持抗逆转录病毒疗法的坚持。研究人员应该考虑采用频率较低的消息传递干预，其内容和时间是单独定制的，旨在唤起收件人的回复。需要进一步研究，以确定如何最好地优化疗效。
The efficacy of antiretroviral therapy depends on patient adherence to a daily medication regimen, yet many patients fail to adhere at high enough rates to maintain health and reduce the risk of transmitting HIV. Given the explosive global growth of cellular-mobile phone use, text-messaging interventions to promote adherence are especially appropriate. This meta-analysis synthesized available text messaging interventions to promote antiretroviral therapy adherence in people living with HIV. We performed Boolean searches of electronic databases, hand searches of recent year conference abstracts and reverse searches. Included studies (1) targeted antiretroviral therapy adherence in a sample of people living with HIV, (2) used a randomized-controlled trial design to examine a text messaging intervention, and (3) reported at least one adherence measurement or clinical outcome. Eight studies, including 9 interventions, met inclusion criteria. Text-messaging interventions yielded significantly higher adherence than control conditions (OR = 1.39; 95% CI = 1.18, 1.64). Sensitivity analyses of intervention characteristics suggested that studies had larger effects when interventions (1) were sent less frequently than daily, (2) supported bidirectional communication, (3) included personalized message content, and (4) were matched to participants’ antiretroviral therapy dosing schedule. Interventions were also associated with improved viral load and/or CD4+ count (k = 3; OR = 1.56; 95% CI = 1.11, 2.20). Text-messaging can support antiretroviral therapy adherence. Researchers should consider the adoption of less frequent messaging interventions with content and timing that is individually tailored and designed to evoke a reply from the recipient. Future research is needed in order to determine how best to optimize efficacy.
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