Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial.
Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial.
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DOI：
10.2196/mhealth.9031
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发表时间：
2018-05-17
影响因子：
5
通讯作者：
Haberer JE
中科院分区：
文献类型：
--
作者：
Musiimenta A;Atukunda EC;Tumuhimbise W;Pisarski EE;Tam M;Wyatt MA;Ware NC;Haberer JE
无线电子依从性监测器可以检测抗逆转录病毒治疗（ART）依从性的失误，并在真实的时间触发干预措施，从而可能避免不必要的艾滋病毒血症。然而，关于这些监测器和相关干预措施的可接受性和可行性的证据有限。本研究的目的是评估与短信（短消息服务，SMS）提醒和通知相关的实时依从性监测的可接受性和可行性，以支持在乌干达西南部农村接受抗逆转录病毒治疗的艾滋病毒感染者的依从性。开始ART的HIV感染者参加了一项试点随机对照试验，并随访9个月。参与者接受实时依从性监测，并随机分配至以下研究组之一：（1）计划的SMS，（2）错过或延迟剂量触发的SMS，或（3）无SMS。还向45名患者识别的社会支持者发送了短信通知，以了解计划短信和触发短信臂中的持续依从性失误。研究参与者和社会支持者参加了定性的半结构化的深入访谈，这种技术的可接受性和可行性。一个归纳，内容分析法，框架内的统一理论的接受和使用的技术模型，用于分析定性数据。根据以电子方式收集并连续总结的器械指标记录定量可行性数据，包括器械功能和SMS跟踪数据。共有63名参与者参加了这项研究。参与者报告称，与短信提醒和通知相关的实时监测干预通常是可以接受的;主要反馈是感知效用-干预有利于激励和提醒患者服药，以及提供社会支持。该干预措施在技术上是可行的，因为在大多数情况下，从大多数参与者那里获得了预期的数据。潜在的挑战包括技术对保密性的影响，共享电话所有权，可用性技能和电力供应。在资源有限的国家，结合短信提醒和社会支持通知的实时依从性监测是一种普遍可接受的（主要基于感知效用）和可行的干预措施。未来的工作重点应放在优化器械设计、用户培训以克服我们遇到的挑战、成本效益研究以及研究器械的监测方面，而无需伴随干预。ClinicalTrials.gov NCT 01957865; https://clinicaltrials.gov/ct2/show/NCT01957865（由WebCite在http：//www.webcitation.org/6zFiDlXDa上存档）
Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda. Individuals living with HIV who were initiating ART were enrolled in a pilot randomized controlled trial and followed up for 9 months. Participants received a real-time adherence monitor and were randomized to one of the following study arms: (1) scheduled SMS, (2) SMS triggered by missed or delayed doses, or (3) no SMS. SMS notifications were also sent to 45 patient-identified social supporters for sustained adherence lapses in the scheduled SMS and triggered SMS arms. Study participants and social supporters participated in qualitative semistructured in-depth interviews on acceptability and feasibility of this technology. An inductive, content analytic approach, framed by the unified theory of acceptance and use of technology model, was used to analyze qualitative data. Quantitative feasibility data, including device functionality and SMS tracking data, were recorded based upon device metrics collected electronically and summarized descriptively. A total of 63 participants participated in the study. Participants reported that real-time monitoring intervention linked to SMS reminders and notifications are generally acceptable; the predominant feedback was perceived utility—the intervention was beneficial in motivating and reminding patients to take medication, as well as enabling provision of social support. The intervention was found to be technically feasible, as data were obtained from most participants as expected most of the time. Potential challenges included the impact of the technology on confidentiality, shared phone ownership, usability skills, and availability of electricity. Real-time adherence monitoring integrated with SMS reminders and social support notifications is a generally acceptable (based primarily on perceived utility) and feasible intervention in a resource-limited country. Future efforts should focus on optimized device design, user training to overcome the challenges we encountered, cost effectiveness studies, as well as studying the monitoring aspect of the device without accompanying interventions. ClinicalTrials.gov NCT01957865; https://clinicaltrials.gov/ct2/show/NCT01957865 (Archived by WebCite at http://www.webcitation.org/6zFiDlXDa)
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
12.7
作者：
Linnemayr, Sebastian;Huang, Haijing;Mukasa, Barbara
通讯作者：
Mukasa, Barbara
影响因子：
3.7
作者：
Phillips AN;Cambiano V;Nakagawa F;Bansi-Matharu L;Sow PS;Ehrenkranz P;Ford D;Mugurungi O;Apollo T;Murungu J;Bangsberg DR;Revill P
通讯作者：
Revill P
与标准的电子依从性监测相比，实时电子依从性监测和随访可提高依从性。
DOI：
10.1097/qad.0000000000001310
发表时间：
2017-01-02
期刊：
AIDS (London, England)
影响因子：
--
作者：
Haberer JE;Musinguzi N;Tsai AC;Boum Y 2nd;Bwana BM;Muzoora C;Hunt PW;Martin JN;Bangsberg DR
通讯作者：
Bangsberg DR
影响因子：
168.9
作者：
Lester, Richard T.;Ritvo, Paul;Plummer, Francis A.
通讯作者：
Plummer, Francis A.