Perceptions of People Living with HIV and HIV Healthcare Providers on Real-Time Measuring and Monitoring of Antiretroviral Adherence Using Ingestible Sensors: A Qualitative Study.

Susan Kamal,Marc I Rosen,Christina Lazar,Honghu Liu,Yan Wang,Eric S Daar,Lisa Siqueiros

doi:10.1155/2020/1098109

Abstract

Objective To describe and analyze the perception and attitudes of people living with HIV (PLWH) and HIV HCPs towards medication adherence with a focus on a digital medicine program (DMP) with ingestible sensors (ISs). Methods This is a qualitative analysis pilot study of PLWH who were using DMP recruited by purposive sampling. A convenience sample of HCPs was interviewed. Semistructured interviews were conducted, and thematic analysis was performed. Results Fifteen PLWH were interviewed, and thematic analysis resulted in three main themes: self-identified medication adherence patterns, experiences with the DMP, and recommending the DMP to others. Six health care providers (HCPs) described barriers and facilitators to adherence, as well as advantages and disadvantages of using or recommending the DMP to PLWH. Conclusion This study evaluated participant and provider responses to DMP, which is a novel technology for real-time measuring and monitoring adherence with the IS. Participant and provider responses were mixed, highlighting both the advantages and limitations of the technology. Practice Implications. Taking PLWH experiences into consideration will enhance the development of this and other useful tools that clinicians and researchers can use for enhanced patient care.

Highlights

Six health care providers (HCPs) were included and are described in Table 2. e thematic analysis resulted in themes pertaining to the following broad topics: self-identified patient medication adherence patterns; experiences with the digital medicine program (DMP) system including the patch, the pill, the text messages, and the tablet; opinions on the DMP system technical support; recommendations for improving the system for patient interviews
We describe and analyze people living with HIV (PLWH) experiences and HIV HCPs’ opinions on real-time adherence monitoring with a focus on the DMP. e views of PLWH and HCPs were very similar. ey only differed on the in-depth explanation of facilitators and barriers to ARV adherence, where HCPs provided more comprehensive reasons on why their patients were not adherent
Both PLWH and HCPs agreed that DMP can be helpful in the management of ARV adherence. is was reported by persons living with schizophrenia and their HCPs [24] and PLWH who used other real-time ARV adherence monitoring devices such as Med-e-Monitor and Wisepill© [25, 26]

Summary

Methods

PLWH were recruited as part of an open-label pilot study preceding an ongoing clinical trial E inclusion criteria were as follows: HIV-infected individuals in HIV care; greater than 17 years of age; able to take coencapsulated ARVs at the time of screening; able to provide informed consent; on ART with current or at an increased risk of suboptimal adherence estimated by either the patient (self-reports < 90% adherence over last 28 days by asking patients how many doses were missed) or treating HCP perception (e.g., based on missed clinic visits or viral load elevations (viral load >200 copies/mL) within the last 6 months). Semistructured telephone interviews were conducted three days after beginning use of the system and again at week two and at the first of the monthly face-to-face data collection visits for the DMP pilot study. S.), who was trained in qualitative interviewing and was provided with a semistructured interview guide (Appendix I-a). e interview guide referred to this adherence measuring and monitoring system as the Ingestion Sensory System but is referred to here as the DMP

Results

Discussion

Conclusion