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Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study

BACKGROUND: In randomized controlled trials, short message service (SMS) programs have improved adherence to HIV antiretroviral therapy (ART). In response, the World Health Organization recommended use of SMS programs to support ART. However, there is limited data on real-world implementations of SM...

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Autores principales: Georgette, Nathan, Siedner, Mark J., Petty, Carter R., Zanoni, Brian C., Carpenter, Stephen, Haberer, Jessica E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319177/
https://www.ncbi.nlm.nih.gov/pubmed/28219372
http://dx.doi.org/10.1186/s12911-017-0413-9
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author Georgette, Nathan
Siedner, Mark J.
Petty, Carter R.
Zanoni, Brian C.
Carpenter, Stephen
Haberer, Jessica E.
author_facet Georgette, Nathan
Siedner, Mark J.
Petty, Carter R.
Zanoni, Brian C.
Carpenter, Stephen
Haberer, Jessica E.
author_sort Georgette, Nathan
collection PubMed
description BACKGROUND: In randomized controlled trials, short message service (SMS) programs have improved adherence to HIV antiretroviral therapy (ART). In response, the World Health Organization recommended use of SMS programs to support ART. However, there is limited data on real-world implementations of SMS programs. METHODS: We conducted a retrospective cohort study of an SMS program to improve ART adherence in a government-run HIV clinic in rural South Africa. We analyzed data from all adult patients who 1) enrolled at the clinic before the observation period (July 2013 through June 2014), 2) had ≥1 ART prescriptions in the observation period, and 3) had data on phone number availability (N = 2255). Our main outcome measure was prescription coverage, defined as the presence of a valid ART prescription for each day observed. We fit generalized linear mixed models adjusted for pre-program prescription coverage, demographics, and ART duration, dosing, and regimen. RESULTS: Exposure to the SMS program was independently associated with greater prescription coverage (AOR = 1.23, 95% CI 1.13–1.34, P < 0.001) compared with non-exposure, although the absolute increase in prescription coverage was small (4.7 days of ART prescription coverage per average patient per year). Among a subset of patients (n = 725) whose pre-program prescription coverage was <100%, the corresponding mean expected absolute increase in prescription coverage was 8.2 days per year. CONCLUSIONS: Our primary finding was that an SMS reminder program implemented in routine clinical care was associated with a small increase in prescription coverage of uncertain clinical significance.
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spelling pubmed-53191772017-02-24 Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study Georgette, Nathan Siedner, Mark J. Petty, Carter R. Zanoni, Brian C. Carpenter, Stephen Haberer, Jessica E. BMC Med Inform Decis Mak Research Article BACKGROUND: In randomized controlled trials, short message service (SMS) programs have improved adherence to HIV antiretroviral therapy (ART). In response, the World Health Organization recommended use of SMS programs to support ART. However, there is limited data on real-world implementations of SMS programs. METHODS: We conducted a retrospective cohort study of an SMS program to improve ART adherence in a government-run HIV clinic in rural South Africa. We analyzed data from all adult patients who 1) enrolled at the clinic before the observation period (July 2013 through June 2014), 2) had ≥1 ART prescriptions in the observation period, and 3) had data on phone number availability (N = 2255). Our main outcome measure was prescription coverage, defined as the presence of a valid ART prescription for each day observed. We fit generalized linear mixed models adjusted for pre-program prescription coverage, demographics, and ART duration, dosing, and regimen. RESULTS: Exposure to the SMS program was independently associated with greater prescription coverage (AOR = 1.23, 95% CI 1.13–1.34, P < 0.001) compared with non-exposure, although the absolute increase in prescription coverage was small (4.7 days of ART prescription coverage per average patient per year). Among a subset of patients (n = 725) whose pre-program prescription coverage was <100%, the corresponding mean expected absolute increase in prescription coverage was 8.2 days per year. CONCLUSIONS: Our primary finding was that an SMS reminder program implemented in routine clinical care was associated with a small increase in prescription coverage of uncertain clinical significance. BioMed Central 2017-02-20 /pmc/articles/PMC5319177/ /pubmed/28219372 http://dx.doi.org/10.1186/s12911-017-0413-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Georgette, Nathan
Siedner, Mark J.
Petty, Carter R.
Zanoni, Brian C.
Carpenter, Stephen
Haberer, Jessica E.
Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title_full Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title_fullStr Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title_full_unstemmed Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title_short Impact of a clinical program using weekly Short Message Service (SMS) on antiretroviral therapy adherence support in South Africa: a retrospective cohort study
title_sort impact of a clinical program using weekly short message service (sms) on antiretroviral therapy adherence support in south africa: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319177/
https://www.ncbi.nlm.nih.gov/pubmed/28219372
http://dx.doi.org/10.1186/s12911-017-0413-9
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