Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 31, 2019
Date Accepted: Dec 16, 2019
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Preliminary Effects of a mobile interactive supervised therapy intervention for improving the medication adherence of people living with HIV in Singapore: A pilot randomized controlled trial
ABSTRACT
Background:
As people living with human immunodeficiency virus (HIV) infections require lifelong treatments, non-adherence to medications will reduce their chances of being cured, increase their risks of developing drug resistance, and spread their diseases to their communities.
Objective:
The aim of this study was to evaluate the effectiveness of a mobile application—mobile interactive supervised therapy (MIST)—for improving adherence to oral HIV medications among HIV infected adults in Singapore.
Methods:
In a two-group pilot randomized controlled trial with a process evaluation, 40 HIV infected participants with once daily medication regimes were recruited from a public tertiary hospital in Singapore and then randomly assigned to either the intervention or control groups. The intervention lasted for two months. The outcomes included antiretroviral therapy (ART) adherence as measured by a seven-day recall self-report, pill count, an electric medical device—Medical Event Monitoring System (MEMS)—and MIST. Twenty participants from the intervention group were interviewed at the end of the intervention to assess the acceptability of MIST. Data were collected at the baseline and at one-month and two-month post-intervention.
Results:
All participants were excellent medication adherers at the baseline (Median = 100, IQR = 100- 100). The use of MIST did not result in a significant improvement in ART adherence when measured by self-report, pill count and MEMS, as compared to control group at one-month and two-month post intervention. ART adherence also did not improve in each group over the same period. MIST was perceived to be a beneficial and acceptable technology based on the process evaluation results.
Conclusions:
While MIST did not enhance medication adherence to HIV treatments, mainly due to the ceiling effect, it was perceived to be beneficial and acceptable among our participants. Our process evaluation provided useful data to further develop MIST for bigger and longer-term mobile phone application-assisted intervention randomised controlled trials in the future. Clinical Trial: ClinicalTrials.gov- NCT03794648
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