Abstract
BackgroundIncomplete adherence to antiretroviral therapy (ART) is one of the factors that contribute to HIV drug resistance, and it is a major problem for the public health system in controlling the HIV pandemic. There is emerging evidence that SMS can play an important role in health care delivery among patients with HIV on ART, especially in resource-limited settings.ObjectiveThis paper aims to assess the impact of two-way and one-way SMS text messaging on adherence to HIV treatment. We hypothesized that sending weekly text messages through the one-way and two-way SMS text messaging approach will improve adherence to ART among patients with HIV and improve associated clinical outcomes (quality of life).MethodsA randomized controlled trial is being carried out among participants with HIV who have been on ART for at least one month from an accredited treatment center, namely the Buea Regional Hospital and Kumba District Hospital of South West Region, Cameroon. Participants with HIV, both male and female, aged 21 years and older make up a sample size of 207. The interventions involved the use of mobile phone text messages. Before commencing the intervention, a focus group discussion was carried out among the participants to understand their perception about the use of SMS-based interventions to improve adherence. A total of 246 participants were randomized to receive either a one-way text message (SMS sent to a recipient without recipient sending a reply) or two-way text message (SMS sent to a recipient and recipient sends a reply) or the control (no SMS, only standard care). Data on adherence and quality of life were collected at baseline and after 6 months and will be analyzed using SPSS version 21, while qualitative data will be analyzed using Atlas.ti 7.5.ResultsData collection began in September 2019 with focus group discussions and baseline data collection. After 1 month of baseline data collection, the intervention began in October 2019, and postintervention data were collected after 6 months (March 2020). At the end of the study, we will be able to understand the perception of patients toward SMS text messaging–based interventions and also assess the impact of one-way and two-way SMS text messages on treatment adherence among patients with HIV and on associated clinical outcomes (quality of life).ConclusionsThe impact of SMS text messaging varies across different settings. The results from this study will determine the perception of patients toward an SMS text messaging–based intervention and its impact on adherence to ART.International Registered Report Identifier (IRRID)DERR1-10.2196/16127
Highlights
Medication adherence is defined by the World Health Organization as the degree to which a person's behavior corresponds with the agreed recommendations from a health care provider or as the extent to which the patient's history of therapeutic drug taking coincides with the prescribed treatment
Data collection began in September 2019 with focus group discussions and baseline data collection
At the end of the study, we will be able to understand the perception of patients toward SMS text messaging–based interventions and assess the impact of one-way and two-way SMS text messages on treatment adherence among patients with HIV and on associated clinical outcomes
Summary
Medication adherence is defined by the World Health Organization as the degree to which a person's behavior corresponds with the agreed recommendations from a health care provider or as the extent to which the patient's history of therapeutic drug taking coincides with the prescribed treatment. The Joint United Nations Programme for HIV and AIDS (UNAIDS) has defined new ambitious targets that call for 90% of people living with HIV to know their status, 90% of those diagnosed to receive antiretroviral therapy (ART), and 90% of those on treatment to achieve an undetectable viral load. This is known as the 90-90-90 target [1]. In sub-Saharan Africa, where the majority of people receiving antiretroviral therapy live, timely access to HIV diagnosis and linkage to care remain the main challenges to achieving the 90-90-90 objective. There is emerging evidence that SMS can play an important role in health care delivery among patients with HIV on ART, especially in resource-limited settings
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