Text Reminders Improve Adherence to Antiretroviral Therapy.

A real-time monitoring device that sends a text reminder to patients if they do not open their pill container within 30 minutes of a scheduled dose significantly improves adherence to antiretroviral therapy, new research presented this week by a BUSPH researcher shows.

Lora Sabin, associate professor of international health, presented her research at the 9th International Conference on HIV Treatment and Prevention Adherence in Miami.

“One of the limitations of electronic drug-monitoring feedback is that you are not able to intervene in real time to give patients feedback on how they are doing,” Sabin told Medscape Medical News.

To remedy that, Sabin and fellow researchers combined real-time cell phone reminders, triggered by a Wisepill Web-linked medication container, with monthly counseling.

“This two-part intervention was incredibly effective at improving adherence among both high- and low-adherer groups,” Sabin said.

The China Adherence through Technology Study (CATS) was designed to evaluate the effect of the real-time feedback on adherence rates. All study participants were provided with a Wisepill Web-linked medication container for one antiretroviral medication, and adherence was tracked for three months. Patients were put into two groups: those who complied with their medication at least 95 percent of the time and were deemed to have optimal adherence, and those who did not meet that threshold.

At the three-month mark, mean adherence rates were approximately 92 percent in both groups. Patients were then randomized to an intervention or control group.

Patients in the intervention group received a text reminder whenever their device failed to open within 30 minutes of a scheduled dose. Adherence data from the Wisepill device was then discussed during a monthly counseling session.

The patients in the control group received no text messages, and Wisepill adherence data were not discussed during the monthly counseling sessions.

At nine months, mean overall adherence was better in the intervention group than in the control group — 96.4 percent vs. 89.2 percent. And more patients in the intervention group achieved optimal adherence.

For patients who had failed to take their dose within the 30-minute timeframe, compliance was better during the subsequent 30 minutes in the intervention group than in the control group.

The findings suggest that immediate feedback does have a real impact on adherence rates, Sabin said.

The study was funded by the National Institute on Drug Abuse.

Information for this story came from Medscape Medical News.