The fact that there are so many variations of intervention design in text-messaging trials makes it unclear what specific ingredients actively and successfully promote adherence. ” Text-messaging provides researchers with the flexibility of personalizing message content, promoting bidirectional communication, and pairing message timing to ART dosage schedules –. In a recent systematic review, Horvath and colleagues (2012) found high quality evidence of efficacy in interventions using short weekly messages and World Health Organization guidelines include a strong recommendation to consider text messaging “for promoting adherence to ART as part of a package of adherence interventions. Presently, there are nearly as many mobile-cellular phone subscriptions as there are people in the world in the developing world, there are 89 subscriptions for every 100 people. In the last decade, mobile-cellular phone ownership has seen marked growth throughout the world. One promising approach is the use of electronic text-messaging to deliver behavioral interventions. In order to translate effectively, the practice community requires effective interventions that minimize the necessary financial burden to implement. A number of reviews support the efficacy of behavioral interventions to promote ART adherence –, yet these interventions have diverse approaches and variable financial costs. Although research on adherence behavior shows the importance of adherence counseling on biological outcomes (e.g., viral load, CD4+ levels) implementation costs prove increasingly onerous as healthcare providers continue to be pressured to do “more with less” both in developed countries and in resource-limited settings. The current standard of care in promoting adherence is patients’ contact with their health care providers. Promoting adherence sufficient to achieve viral suppression helps to create optimal outcomes in both individual and public health. Drug-resistant strains of HIV virus may then be spread from the individual to community level through sexual and injection drug use networks. For the individual, poor ART adherence can lead to quicker progression of HIV to AIDS, while increasing the potential for the development of ART-resistant viral strains –. In one recent meta-analysis of 84 observational studies, nearly 40% of participants reported less than 90% adherence. The efficacy of antiretroviral therapy (ART) 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. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. Pellowski) and grant R01-MH58563 (PI: Blair T. Public Health Service Institutional National Research Service Award T32-MH074387 (PI: Seth C. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: This research was supported by U.S. Received: AugAccepted: JanuPublished: February 5, 2014Ĭopyright: © 2014 Finitsis et al. PLoS ONE 9(2):Įditor: Alan Winston, Imperial College London, United Kingdom Citation: Finitsis DJ, Pellowski JA, Johnson BT (2014) Text Message Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A Meta-Analysis of Randomized Controlled Trials.
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