Daily Text Reminders Improve ART Adherence

Nonadherence to antiretroviral therapy (ART) can significantly reduce life expectancy due to poor health outcomes for youth and teenage patients with HIV or AIDS. Text message reminders are a feasible and acceptable method to improve medication adherence among teenagers with HIV or AIDS, although larger studies are needed to assess related health outcomes.

The research, which was published in the March 2012 edition of the Journal of Medical Internet Research, analyzed whether short message service (SMS) or text reminders could improve medication adherence among patients aged 14 to 29 years with previously documented poor adherence. Participants had an average age of 23 years, and 92% were men, 60% were black, and 84% reported being infected through unprotected sex. Participants also had use of a personal cell phone as part of the inclusion criteria.

During the study, participants received daily SMS or text reminders, and a follow-up message to assess whether they took their medication. The follow-up message prompted a response about medication adherence, where participants could indicate whether they took or skipped the medication dose.

Researchers sent and received 15,387 messages during the study. Of the medication reminders and follow-up messages, 1167 messages were not delivered and 14,220 were sent successfully. Researchers reported receiving 3414 text message replies to the 7110 follow-up messages requesting a response.

Researchers conducted follow-up visits at 6, 12, 18, and 24 weeks to assess adherence using visual analogue scale and the AIDS Clinical Trial group adherence questionnaire, as well as satisfaction surveys.

Improvements in medication adherence were seen at 6 weeks, and maintained throughout the 24-week study period. Although there was no significant difference in CD4 cell count or viral load during the study, the results showed a small trend toward improvement.

At the 24-week follow-up, 17 of 21 participants who completed the study said they would like to continue receiving the reminder text messages, finding the reminders helped them miss fewer doses of medication. Reasons participants did not find reminders helpful included not being able to check messages at the time they received the reminder, not having the medications on hand, living accommodation changes, and being in a place where they did not feel comfortable taking medication.