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. 2018 Apr;9(2):450-466.
doi: 10.1055/s-0038-1660516. Epub 2018 Jun 20.

A Systematic Review on Promoting Adherence to Antiretroviral Therapy in HIV-infected Patients Using Mobile Phone Technology

Yuri Quintana  1   2 , Eduardo A Gonzalez Martorell  2 , Darren Fahy  1 , Charles Safran  1   2
Affiliations

A Systematic Review on Promoting Adherence to Antiretroviral Therapy in HIV-infected Patients Using Mobile Phone Technology

Yuri Quintana et al. Appl Clin Inform. 2018 Apr.

Abstract

Objective: Adherence to antiretroviral therapy (ART) is paramount to successful long-term suppression of human immunodeficiency virus (HIV). For poorly adherent patients with HIV, barriers to remaining adherent may be overcome by the implementation of targeted interventions delivered via mobile devices. This systematic review is focused specifically on mobile phone technologies to deliver adherence interventions in HIV/acquired immunodeficiency syndrome (AIDS) populations.

Methods: This review (PROSPERO #CRD42017065131) systematically extracted data from published literature from five databases on mobile phone interventions to improve adherence to ART for HIV. The reported studies had been conducted between 2007 and 2017. Risk of bias was assessed using the Cochrane method ranking each criterion as low, high, or unclear risk of bias.

Results: Of the 835 articles returned, we identified 26 randomized controlled trials (RCTs), retrospective and prospective cohort trials, or mixed method studies with a comparison group that fit criteria for inclusion. No standard measure of adherence was consistent throughout the examined studies, and assessments by self-report, pill counting, and medication event monitoring system (MEMS) were utilized. The studies reported mixed results, with 17 reporting significant improvements to adherence, 3 reporting improvements without supplying p-values, and 6 reporting no significant change or a reduction in adherence.

Conclusion: The mixed nature of the results exemplifies the need for more comprehensive approaches and larger scale trials to confirm results observed in limited cohort sizes. To better retain satisfactory adherence within the HIV population, and especially in low-resource settings, we recommend that future interventions incorporate multiple strategies: mobile-based reminders, social support structures, and personalized content.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA flow chart of study selection. AIDS, acquired immunodeficiency virus; HIV, human immunodeficiency virus; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Fig. 2
Fig. 2
Types and levels of bias inherent in the individual studies.
See this image and copyright information in PMC

References

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