JMIR Publications

ABSTRACT

Background:

mHealth has shown promise in improving HIV medication adherence globally.

Objective:

Therefore, we analyzed the effectiveness of mHealth on the adherence of antiretroviral therapy in patients living with HIV(PLWH).

Methods:

Randomized controlled trial (RCT) studies on association between mHealth and medication adherence of antiretroviral treatment (ART) published up until December 2021 were searched out through from electronic databases. Odds ratios, weighted mean difference and 95% confidence intervals were calculated. We evaluated heterogeneity with the I2 statistic. If I2 was≤50%, heterogeneity was absent and a fixed-effect model was used. If I2 was＞50%, heterogeneity existed and a random-effects model was used.

Results:

A total of 2163 participants in 8 studies were included in this meta-analysis. All included studies were randomized controlled trial (RCT). The random-effects model was used to meta-analysis the effects between varieties of intervention measures and routine nursing, and the outcome was not statistically significant (OR=1.54, 95%CI: 0.99-2.38, P= 0.05). In the subgroups, only Short Messaging Service (SMS) significant increase adherence to ART (OR=1.76, 95%CI: 1.07-2.89, P= 0.03). Further analysis showed that only interactive or bidirectional SMS can significantly increase ART adherence (OR=1.69, 95%CI: 1.22-2.34, P=0.001). After combining the difference of CD4 cell count between before and after intervention, it was concluded that there was no statistical heterogeneity among the studies (I2=0%, tau2=0.37, P=0.95).

Conclusions:

Interactive or bidirectional SMS can enhance intervention effects. However, whether mHealth could improve the adherence of antiretroviral therapy in patients with HIV needs further study. Owing to the lack of significant staff time, training or ongoing supervision, there is still a long way to go to apply mHealth to the clinical practice of antiretroviral therapy for PLWH.