Realtime adherence monitoring of antiretroviral therapy among HIV-infected adults and children in rural Uganda
MGH Center for Global Health, 100 Cambridge St, Boston, MA 02114, United States; Harvard Medical School, Boston, United States; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, United States; Mbarara University of Science and Technology, Mbarara, Uganda; University of California, San Francisco, CA, United States
A real-time wireless electronic adherence monitor (EAM) and weekly self-report of missed doses via interactive voice response (IVR) and short message service (SMS) queries were used to measure antiretroviral therapy adherence in 49 adults and 46 children in rural Uganda. Median adherence was 89.5% among adults and 92.8% among children by EAM, and 99-100% for both adults and children by IVR/SMS self-report. Loss of viral suppression was significantly associated with adherence by EAM (odds ratio 0.58 for each 10% increase), but not IVR/SMS. Wireless EAM creates an exciting opportunity to monitor and potentially intervene with adherence challenges as they are happening. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
antiretrovirus agent; nonnucleoside reverse transcriptase inhibitor; virus RNA; antiviral therapy; article; child; drug monitoring; electronic adherence monitor; female; human; Human immunodeficiency virus infection; information system; interactive voice response system; major clinical study; male; medication compliance; monitor; priority journal; rural area; school child; self report; short message service; Uganda; Adult; Anti-Retroviral Agents; Antiretroviral Therapy, Highly Active; Child; Cohort Studies; Female; HIV; HIV Infections; Humans; Longitudinal Studies; Male; Medication Adherence; Reminder Systems; Rural Population; Uganda; Viral Load