Effects of a symptom management intervention based on group sessions combined with a mobile health application for persons living with HIV in China: A randomized controlled trial

OBJECTIVE: This study aims to evaluate the effects of a symptom management intervention (SMI) based on symptom management group sessions combined with a mobile health (mHealth) application (app) on the knowledge of symptom management, the certainty of symptom self-management, symptom severity, symptom distress, medication adherence, social support, and quality of life among persons living with HIV (PLWH) in China. METHODS: A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai, China. The participants in the control group (n = 30) downloaded the Symptom Management (SM) app according to their needs and preferences, and received routine follow-ups. The participants in the intervention group (n = 31) were guided to download and use the SM app, and received four tailored weekly group sessions at routine follow-ups. Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app. All the outcomes were assessed at baseline and post-intervention. The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900024821). RESULTS: The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention (all P < 0.01). Compared with the control group, the scores of symptoms reasons knowledge score improved 11.47 points (95% CI: 3.41, 19.53) and scores of symptoms self-management knowledge score improved 12.80 points (95% CI: 4.55, 21.05) in the intervention group after controlling for covariates. However, other outcomes did not show statistically significant differences between the intervention group and the control group (P > 0.05). CONCLUSION: The SMI could improve PLWH’s symptom management knowledge and certainty of symptom self-management. Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress. More innovative strategies are also needed to promote and maintain the sustainability of the SM app.