Trial | Delivery mechanism | Trial design, Country, Device, Media, Intervention length | Participants | Aims | Intervention | Behavioural Change Theory, interactivity, link to support | Abraham and Michie Taxonomy | Comparator |
---|---|---|---|---|---|---|---|---|
TEXT MESSAGE | ||||||||
Da Costa 2012 [31] | Text message 5 times a week | RCT, Brazil, mobile phone, SMS, 4 month | 21 HIV infected adults. 100% female | To assess whether a warning system based on mobile SMS increases the adherence (95%) of HIV-infected Brazilian women to ART regimens and their impression and satisfaction with respect to incoming messages. | Participants received SMS messages 30 min before their last scheduled time for a dose of medicine during the day. Sent Saturday, Sunday, and alternate days during the working week | Social support 3.1, prompts 7.1 | Monthly multidisciplinary attendance, no text messages | |
Pop-Eleches 2011 [32] | Weekly, daily, short and long text message | Parallel group RCT 5 arms, Kenya, mobile phone, SMS, 48 weeks | 431 HIV infected adults, initiated ART less than 3 months ago. 66% female. | To test the efficacy of SMS reminders on adherence (90%) to ART among patients attending a rural clinic in Kenya. | Participants received SMS reminder that were either short or long and sent at a daily or weekly frequency. | Social support 3.1, prompts 7.1 | No SMS messages | |
Mbuagbaw 2012 [33] | Weekly text message | Parallel RCT, Cameroon, mobile phone, text message, 6 months | 200 HIV positive adults, 21 years and above, been on ART for 1 month. 73.5% female. | To test the effectiveness of sending weekly motivational text messages via mobile phone to improve adherence. | Weekly standardised motivational text message | Health belief model of behaviour change. Link to support - SMS contained a phone number they could call back if they needed help | Social support 3.1, prompts 7.1 | Standard care and no text message |
Hardy 2011 [30] | Daily text message | Parallel RCT, America (Boston), mobile phone, message, 6 weeks | 23 HIV infected adults, on ART for at least 3 months but less than 85% adherence. 39% female. | To compare the efficacy of a personalized cell phone reminder system (A remind) in enhancing adherence to ART versus a beeper. | Personalised text messages daily to match ART dosing frequency, beep every 15 min till patient acknowledges message. | Interactivity - participant instructed to respond with an SMS in order to confirm they were taking medication. It would bleep every 15 min | prompts 7.1 | Beeper, reminder beeper at the time of dosing, beeps once for 30 s then no repeats. |
Sabin 2015 [34] | SMS text reminder | RCT, China, 9 month | 119 participants. Age 18+, deemed at risk of poor adherence, 36.1% female | Hypothesized that adherence information and education likely to be effective when delivered in real time and in direct response to lapses when they occur. To assess the effect of real-time feedback using triggered cell phone reminders coupled with Wisepill generated data enhanced counselling. | Adherence counselling and SMS phone reminder when the Wisepill system failed to detect 30 mins post scheduled dose time. Monthly clinic if adherence < 95% - received behaviourally targeted counselling session with a counsellor guided by performance report | Feedback on behaviour 2.2 Prompt 7.1 Social support 3.1 | Monthly clinic if adherence < 95% - received behaviourally targeted counselling session with a counsellor guided by performance report | |
Ingersoll 2015 [35] | Automated SMS text message | RCT, USA (Virginia), 12 weeks | 63 participants. Age 18+, 39.7% female. Less than 95% adherence used illicit drugs and drank risky amounts of alcohol | Test the preliminary efficacy of a theory based bi-directional text message intervention on ART adherence, missed care visits and substance use among people with HIV | Daily queries of ART adherence, mood and substance use. The system sent contingent intervention messages by participants for reports of medication dosing, mood and substance use | Interactivity – bidirectional texting Behaviour change Theory – Information, motivation and behaviour skills model of adherence and social action theory. Individual change model | Social support 3.1, Monitoring of emotional consequences 5.4, Prompt 7.1 | HIV primary care, speciality service, medical case management, pharmacist adherence support, psychological care and substance abuse counselling |
Haberer 2016 [36] | SMS message | RCT, Uganda, 9 months | 62 people with HIV, 65% female and their social supporters. | RCT of multiple types of interventions based on SMS and real time adherence monitoring to improve adherence among individuals initiating ART in Uganda | 1) Scheduled SMS – SMS daily for 1 month, then weekly for 2 months, then for the next 6 months only if no signal within 2 h, and SMS to social supporter if no signal 48 h + real time adherence monitoring 2) Triggered SMS only if no signal within 2 h of dosing, last 6 months SMS sent to social supporter + real time adherence 3) real time adherence only | Feedback on behaviour 2.2, Social support 3.1, Prompt 7.1 Social supporter had a text message | Real time adherence no SMS reminders | |
Nsagha 2016 [28] | SMS message | RCT, Cameroon, 1 month | 90 people living with HIV and AIDS who had been on ARV for 1 month. 61% female, aged 18 and above 95% adherence | To assess the usefulness of cell phone text messages to improve the adherence (95%) of HIV and AIDS patients to their treatment and care in the NW region of Cameroon | Educative SMS messages, four times a week for 4 weeks | Prompt 7.1 | Usual care – no details | |
Orrell 2015 [37] | Text message | RCT South Africa, 48 weeks | 230 ART naïve. 65.2% female. Adherence more than 80% | Determine if text message triggered by missed doses would improve overall daily adherence execution in ART naïve South African adults | Participants preferred daily dosing time recorded in the EMS and if device not opened within 30 min of scheduled dosing time – text message sent. | Feedback on behaviour 2.2 Prompt 7.1 | 3 group treatment preparedness sessions before or within the first month of commencing ART. Delivered by HIV positive peer counsellors. | |
VOICE CALL | ||||||||
Belzer 2014 [38] | Daily phone call | Longitudinal RCT, America, mobile phone, voice calls, 48 weeks | 37 youth (age 15-24) with HIV, history of non-adherence. 37% were females. Half the youth were perinatally infected. | To determine if daily cell-phone conversation with health-care providers around self-care and taking HIV management would lead to successful self-administration of ART in HIV infected adolescents with poor medication adherence (< 90%). | Calls Monday to Friday either once or twice a day. Confirmed if medications were taken, provided problem-solving support and referred to services to address adherence barriers. | Link to support - adherence facilitator did a mediation review, problem solving and scheduling relevant referrals. | Goals and planning 1.2, 1.6, Feedback and monitoring 2.2, Social support 3.1, prompts 7.1 | Usual care |
Huang 2013 [39] | Fortnightly phone call | RCT, China, mobile phone, voice call, 3 months | 196 HIV positive patients, both treatment naïve and treatment experienced. 52% female. | To investigate the effects of a phone call intervention on adherence to ART and QOL of treatment-naïve and treatment-experienced patients. | Reminder phones call every 2 weeks by registered nurse/ health personnel. Discuss medications, self-management and related difficulties. | Link to support - patients were given a hospital phone number and a mobile phone number | Feedback and monitoring 2.1, Social support 3.2 | Usual care - educational on HIV/AIDS and treatment |
Kebaya 2014 [29] | Fortnightly mobile phone call | RCT, Kenya, mobile phone, voice call, 6 weeks | 150 mother- infant pairs, in HIV exposed infants. | To compare self-reported adherence to infant NVP prophylaxis and retention in care in. | Fortnightly mobile phone based reminder and on prevention of mother to child transmission. | prompts 7.1 | Standard health care, no phone calls. | |
Uzma 2011 [40] | Weekly phone call reminders | RCT, Pakistan, mobile phone, voice call, 10 weeks | 76 adult participants, 26.3% females, HIV positive on ART regime for at least 3 months | To assess the efficacy of interventions for improving adherence to ART regimens in patients with HIV/AIDS in treatment centres. | Weekly phone reminders and routine counselling | Goals and planning 1.4, Social support 3.1, prompts 7.1 | Routine counselling | |
Kalichman 2011 [41] | Bi-weekly phone call counselling session | RCT, America (Atlanta), mobile phone, telephone counselling session, 4 months | 40 HIV positive adults with less than 95% self-reported adherence. 35% female. | To examine the effect of a brief cell phone-delivered adherence intervention designed to improve medication adherence in people living with HIV/AIDS | 45 min counselling session with feedback and adherence counselling after pill count calls, which were bi-weekly. | Behavioural self management model, self-regulation models of medication adherence Link to support - counsellor initiated calls and check in on how participants were doing | Goals and planning 1.1, Feedback and monitoring 2.2, 2.3, Social support 3.1, 3.2, Natural consequence 5.1 | Pill counts checked over the phone, no feedback on adherence or counselling. |
MIXED | ||||||||
Maduka 2013 [45] | Mixed- twice a week text message and monthly adherence counselling | RCT, Nigeria, mobile phone, short message reminders, 4 months | 104 participants, 56.7% female, HIV positive been on HAART for 3 months, history of non-adherence | To demonstrate the effect of adherence counselling and text message reminders in improving patient’s adherence to HAART. | Mixed - monthly adherence counselling that lasted 45 - 60 min, and twice weekly short message reminders | Interactivity - trial participants were encouraged to call, “flash” or send an SMS to those numbers to acknowledge receipt of SMS and indicate need for further counselling or information Link to support - researchers phone contact were added to the receiver category of every message | Social support 3.1, prompts 7.1 | Standard care -included health education, occasional encouragement by doctors & quarterly assessment of CD4 count. |
Lester 2010 [44] | Weekly text message + counselling if required | Parallel group RCT, Kenya, mobile phone, SMS, 12 months | 538 HIV infected, ART naïve adults. 65.6% female. | Assess whether mobile phone communication between health-care workers and patients initiating ART, in Kenya improved drug adherence and suppression of plasma HIV-1 RNA load. | Weekly SMS messages that required a response within 48 h. Structured mobile phone communication between health care workers and patients. | Interactivity - instructed to respond after 48 h if they were doing well or if they had a problem. Those that had a problem the clinician called them back or those who failed to respond. Link to support - SMS reminded them of phone based support | Social support 3.1 | One counselling sessions in Kajido and two in Nairobi. Additional brief counselling at each site provided during dispensation of the drugs in the clinic or pharmacy. |
Shet 2014 [43] | Automated weekly voice message + weekly pictorial message | Parallel group RCT, India, mobile phone, automated voice call and pictorial message 96 weeks | 631 HIV infected, ART naïve adults. 43.3% women. | To assess whether customised mobile phone reminders would improve adherence to therapy and thus decrease virological failure among HIV infected patients started ART | Customised, interactive automated voice reminder and a pictorial message sent weekly to the patient’s mobile phones. | Social cognitive theory of planned behaviour Interactivity - required patient to respond about previous days dosing. If there was no response to the call then three more attempts were made until a response was obtained. | Feedback and monitoring 2.1, Social support 3.1 | Standard care included 3 counselling sessions prior to the initiation of ART, routine clinical and lab testing at baseline, follow up and assessments every 6 months |
Abdulrahman 2017 [46] | SMS and telephone call reminder | Single blinded RCT, Malaysia, SMS and telephone call reminder + adherence counselling, 24 weeks | 242 Adult HIV positive new to ART. 12% female. Excluded pregnant/HIV patients already on/restarted ART and foreigners. | Evaluate the effectiveness of mobile phone reminders and peer counselling in improving adherence and treatment outcome among HIV positive patients on ART in Malaysia | Weekly medication reminder SMS 3 days prior to app, telephone call reminders (90 s during lunch hours) for scheduled clinic appointments and peer counselling during clinical visits (minimum of 3 visits) | Link to support - not mandatory to respond but could text back for additional support | Prompt 7.1 | Standard care – routine adherence counselling and paper based appointment scheduling by two training research assistants |
IMAGING | ||||||||
Perera 2014 [42] | Daily imaging | RCT, New Zealand, smartphone application, imagery, 3 months | 28 adults on ART for at least 6 months, 7% female. | To examine the efficacy of a smartphone application incorporating personalized health related visual imagery with real-time information about medication level and immune-protection to enhance adherence to ART. | Augmented version contained components that illustrated participant’s current estimated plasma concentration of ART and the immune protection. | Feedback and monitoring 2.2, prompts 7.1 | Standard version of smartphone application, which comprised a 24-h medication clock, displaying the participants daily ART dosing schedule. Patients could record when they had taken their medication each day. |