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Text Message Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A Meta-Analysis of Randomized Controlled Trials

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  • David J Finitsis
  • Jennifer A Pellowski
  • Blair T Johnson

Abstract

Background: The efficacy of antiretroviral therapy depends on patient adherence to a daily medication regimen, yet many patients fail to adhere at high enough rates to maintain health and reduce the risk of transmitting HIV. Given the explosive global growth of cellular-mobile phone use, text-messaging interventions to promote adherence are especially appropriate. This meta-analysis synthesized available text messaging interventions to promote antiretroviral therapy adherence in people living with HIV. Methods: We performed Boolean searches of electronic databases, hand searches of recent year conference abstracts and reverse searches. Included studies (1) targeted antiretroviral therapy adherence in a sample of people living with HIV, (2) used a randomized-controlled trial design to examine a text messaging intervention, and (3) reported at least one adherence measurement or clinical outcome. Results: Eight studies, including 9 interventions, met inclusion criteria. Text-messaging interventions yielded significantly higher adherence than control conditions (OR = 1.39; 95% CI = 1.18, 1.64). Sensitivity analyses of intervention characteristics suggested that studies had larger effects when interventions (1) were sent less frequently than daily, (2) supported bidirectional communication, (3) included personalized message content, and (4) were matched to participants’ antiretroviral therapy dosing schedule. Interventions were also associated with improved viral load and/or CD4+ count (k = 3; OR = 1.56; 95% CI = 1.11, 2.20). Conclusions: Text-messaging can support antiretroviral therapy adherence. Researchers should consider the adoption of less frequent messaging interventions with content and timing that is individually tailored and designed to evoke a reply from the recipient. Future research is needed in order to determine how best to optimize efficacy.

Suggested Citation

  • David J Finitsis & Jennifer A Pellowski & Blair T Johnson, 2014. "Text Message Intervention Designs to Promote Adherence to Antiretroviral Therapy (ART): A Meta-Analysis of Randomized Controlled Trials," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-10, February.
    • Handle: RePEc:plo:pone00:0088166
    DOI: 10.1371/journal.pone.0088166
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    Cited by:

    1. Isaac Amankwaa & Daniel Boateng & Dan Yedu Quansah & Cynthia Pomaa Akuoko & Catrin Evans, 2018. "Effectiveness of short message services and voice call interventions for antiretroviral therapy adherence and other outcomes: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-20, September.
    2. Denis Nash & McKaylee M Robertson & Kate Penrose & Stephanie Chamberlin & Rebekkah S Robbins & Sarah L Braunstein & Julie E Myers & Bisrat Abraham & Sarah Kulkarni & Levi Waldron & Bruce Levin & Mary , 2018. "Short-term effectiveness of HIV care coordination among persons with recent HIV diagnosis or history of poor HIV outcomes," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-14, September.
    3. Sarah J Iribarren & Kenrick Cato & Louise Falzon & Patricia W Stone, 2017. "What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    4. Omar Al-Ubaydli & John A. List & Danielle LoRe & Dana Suskind, 2017. "Scaling for Economists: Lessons from the Non-Adherence Problem in the Medical Literature," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 125-144, Fall.
    5. Suresh Rangarajan & Hoang Nguyen Bao Tram & Catherine S Todd & Tran Thinh & Van Hung & Pham Thanh Hieu & Tran My Hanh & Khong Minh Chau & Nguyen Danh Lam & Pham Tri Hung & Gary West & Donn Colby, 2014. "Risk Factors for Delayed Entrance into Care after Diagnosis among Patients with Late-Stage HIV Disease in Southern Vietnam," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-8, October.

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