Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial
Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART). Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV posi...
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| Veröffentlicht in: | PloS one 2017-05, Vol.12 (5), p.e0177698-e0177698 |
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| creator | Abdulrahman, Surajudeen Abiola Rampal, Lekhraj Ibrahim, Faisal Radhakrishnan, Anuradha P Kadir Shahar, Hayati Othman, Norlijah |
| description | Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART).
Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.
A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.
The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.
Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement. |
| doi_str_mv | 10.1371/journal.pone.0177698 |
| format | Article |
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Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.
A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.
The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.
Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0177698</identifier><identifier>PMID: 28520768</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Acquired Immunodeficiency Syndrome - drug therapy ; Adequacy ; Adhesion ; Adolescent ; Adult ; Adults ; AIDS ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiretroviral Therapy, Highly Active - methods ; Biology and Life Sciences ; Cell Phone ; Cellular telephones ; Clinical trials ; Coal mines ; Communities ; Cost analysis ; Covariance ; Data acquisition ; Data collection ; Death ; Developing countries ; Diglycerides ; Discrimination ; Distance Counseling - methods ; Drugs ; Engineering and Technology ; Feedback ; Female ; Guidelines ; Health aspects ; Highly active antiretroviral therapy ; HIV ; Hospitals ; Human immunodeficiency virus ; Humans ; Immunology ; Innovations ; Intervention ; Inventories ; LDCs ; Malaysia ; Male ; Medicine ; Medicine and Health Sciences ; Messages ; Middle Aged ; Morbidity ; Mutation ; Optimization ; Patient Compliance ; Patients ; Peer Group ; People and Places ; Power efficiency ; Pregnancy ; Protocol (computers) ; Psychology ; Public health ; Regression models ; Scheduling ; Social Sciences ; Studies ; Telemedicine - methods ; Text messaging ; Therapy ; Treatment Outcome ; Tuberculosis ; Wireless telephones</subject><ispartof>PloS one, 2017-05, Vol.12 (5), p.e0177698-e0177698</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Abdulrahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Abdulrahman et al 2017 Abdulrahman et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-76059e3829ebb079330337582a27af9e6a35c04093b3e9e04bdbb21caf1960cb3</citedby><cites>FETCH-LOGICAL-c692t-76059e3829ebb079330337582a27af9e6a35c04093b3e9e04bdbb21caf1960cb3</cites><orcidid>0000-0003-4445-1295</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433794/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433794/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28520768$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abdulrahman, Surajudeen Abiola</creatorcontrib><creatorcontrib>Rampal, Lekhraj</creatorcontrib><creatorcontrib>Ibrahim, Faisal</creatorcontrib><creatorcontrib>Radhakrishnan, Anuradha P</creatorcontrib><creatorcontrib>Kadir Shahar, Hayati</creatorcontrib><creatorcontrib>Othman, Norlijah</creatorcontrib><title>Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART).
Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.
A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.
The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.
Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.</description><subject>Acquired immune deficiency syndrome</subject><subject>Acquired Immunodeficiency Syndrome - drug therapy</subject><subject>Adequacy</subject><subject>Adhesion</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>AIDS</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Biology and Life Sciences</subject><subject>Cell Phone</subject><subject>Cellular telephones</subject><subject>Clinical trials</subject><subject>Coal mines</subject><subject>Communities</subject><subject>Cost analysis</subject><subject>Covariance</subject><subject>Data acquisition</subject><subject>Data collection</subject><subject>Death</subject><subject>Developing countries</subject><subject>Diglycerides</subject><subject>Discrimination</subject><subject>Distance Counseling - methods</subject><subject>Drugs</subject><subject>Engineering and Technology</subject><subject>Feedback</subject><subject>Female</subject><subject>Guidelines</subject><subject>Health aspects</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Innovations</subject><subject>Intervention</subject><subject>Inventories</subject><subject>LDCs</subject><subject>Malaysia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Messages</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mutation</subject><subject>Optimization</subject><subject>Patient Compliance</subject><subject>Patients</subject><subject>Peer Group</subject><subject>People and Places</subject><subject>Power efficiency</subject><subject>Pregnancy</subject><subject>Protocol (computers)</subject><subject>Psychology</subject><subject>Public health</subject><subject>Regression models</subject><subject>Scheduling</subject><subject>Social Sciences</subject><subject>Studies</subject><subject>Telemedicine - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abdulrahman, Surajudeen Abiola</au><au>Rampal, Lekhraj</au><au>Ibrahim, Faisal</au><au>Radhakrishnan, Anuradha P</au><au>Kadir Shahar, Hayati</au><au>Othman, Norlijah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-05-16</date><risdate>2017</risdate><volume>12</volume><issue>5</issue><spage>e0177698</spage><epage>e0177698</epage><pages>e0177698-e0177698</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART).
Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.
A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.
The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.
Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28520768</pmid><doi>10.1371/journal.pone.0177698</doi><tpages>e0177698</tpages><orcidid>https://orcid.org/0000-0003-4445-1295</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-05, Vol.12 (5), p.e0177698-e0177698 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1899375967 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Acquired Immunodeficiency Syndrome - drug therapy Adequacy Adhesion Adolescent Adult Adults AIDS Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Antiretroviral Therapy, Highly Active - methods Biology and Life Sciences Cell Phone Cellular telephones Clinical trials Coal mines Communities Cost analysis Covariance Data acquisition Data collection Death Developing countries Diglycerides Discrimination Distance Counseling - methods Drugs Engineering and Technology Feedback Female Guidelines Health aspects Highly active antiretroviral therapy HIV Hospitals Human immunodeficiency virus Humans Immunology Innovations Intervention Inventories LDCs Malaysia Male Medicine Medicine and Health Sciences Messages Middle Aged Morbidity Mutation Optimization Patient Compliance Patients Peer Group People and Places Power efficiency Pregnancy Protocol (computers) Psychology Public health Regression models Scheduling Social Sciences Studies Telemedicine - methods Text messaging Therapy Treatment Outcome Tuberculosis Wireless telephones |
| title | Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial |
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