Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec;14(6):1340-6.
doi: 10.1007/s10461-010-9799-4.

Real-time adherence monitoring for HIV antiretroviral therapy

Jessica E Haberer  1 , Josh Kahane, Isaac Kigozi, Nneka Emenyonu, Peter Hunt, Jeffrey Martin, David R Bangsberg
Affiliations

Real-time adherence monitoring for HIV antiretroviral therapy

Jessica E Haberer et al. AIDS Behav. 2010 Dec.

Abstract

Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and self-report were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The Wisepill device
Fig. 2
Fig. 2
Median adherence levels by multiple measures averaged over the two 3-month study periods. * MEMS data was recorded during the 3 months just prior to the initiation of this study
Fig. 3
Fig. 3
Adherence dot plots for the 14 days prior to detection of the transient, low-level viremia seen in four participants. a HIV RNA 627 copies/ml (6/15/09; first 3-month period); b HIV RNA 134 copies/ml (8/11/09; second 3-month period); c HIV RNA 58 copies/ml (8/18/09; second 3-month period); d HIV RNA 51 copies/ml (8/24/09; second 3-month period)
See this image and copyright information in PMC

References

    1. Kerr T, Walsh J, Lloyd-Smith E, et al. Measuring adherence to highly active antiretroviral therapy: implications for research and practice. Curr HIV/AIDS Rep. 2005;2(4):200–205. doi: 10.1007/s11904-005-0017-3. - DOI - PubMed
    1. Parienti JJ, Das-Douglas M, Massari V, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS One. 2008;3(7):e2783. doi: 10.1371/journal.pone.0002783. - DOI - PMC - PubMed
    1. Bangsberg DR, Deeks SG. Spending more to save more: interventions to promote adherence. Ann Intern Med. 2010;152(1):54–56. - PMC - PubMed
    1. Boyce JM, Cooper T, Dolan MJ. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use. Infect Control Hosp Epidemiol. 2009;30(11):1090–1095. doi: 10.1086/644756. - DOI - PubMed
    1. Walji MF, Coker O, Valenza JA, et al. A persuasive toothbrush to enhance oral hygiene adherence. AMIA Annu Symp Proc. 2008; 1167. - PubMed

Publication types