Dr. Helene Hardy presented one of the select oral abstracts at the 4th International Conference on HIV Treatment Adherence in Miami:
Title: Assess and Remind (ARemind): a Personalized Cell Phone Reminder System is Superior to a Beeper to Enhance Adherence to Antiretroviral Therapy
Background: Adherence to antiretroviral therapy (ART) represents one of the strongest predictor of progression to AIDS, yet innovative technologies are needed to sustain adherence over time. The purpose of this study was to compare the efficacy of a personalized cell phone reminder system called Aremind in enhancing adherence to ART versus a beeper.
Methods: Twenty-three HIV-infected subjects on ART with self-reported adherence <85% were randomized to a cellular phone (CP) or beeper (BP). CP subjects received personalized text messages and had to respond with a text message when taking ART. BP subjects received a reminder beep at the time of dosing. Interviews were schedule every 3 weeks over 6 weeks. Adherence to ART was measured by self-report (SR, 7-day recall), pill count (PC, past 30 days at baseline, then past 3 weeks), and MEMS (cumulatively at 3 and 6 weeks). ANCOVA model adjusted for baseline adherence was used to compare SR and PC adherence changes. T-test was used to evaluate difference between groups for MEMS.
Results: Twelve males and 11 females were enrolled; 19 completed all visits. Mean baseline viral load and CD4 count were 21,309 copies/mL and 295 cells/mm3. Most subjects were on a boosted PI (52.2%) or an NNRTI (17.4%). Past adherence barriers included active substance abuse (73.9%), fear of side effects (69.6%), and lack of daily routine (65.2%). Both SR and PC adherence increased significantly from baseline to week 6 in the CP arm (83.4% to 92.8%, p=0.03; 65.2% to 82.8%, p=0.005). Furthermore, cumulative MEMS adherence (88% vs 60%, p=0.008), average SR adherence (92% vs 75%, p=0.07), and average PC adherence (80% vs 65%, = 0.06) were higher in the CP arm.
Conclusions: Aremind was more successful than a beeper in enhancing adherence to ART in this population. A larger prospective study is necessary to confirm these findings.
Citation: Hardy H, Farmer EK, Kumar V, Jackson J, Myung D, Doros G, Rybin D, Drainoni M, Backman E, Stanic A, Skolnik P. Assess and Remind (ARemind): a Personalized Cell Phone Reminder System is Superior to a Beeper to Enhance Adherence to Antiretroviral Therapy. Fourth International Conference on HIV Treatment Adherence. April 5-7, 2009, Miami, Florida. Abst 0289. Approved for Oral Presentation