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Table 1 Study characteristics

From: Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review

Author (year)

Location of study

Participants

Number (n)

Gender

Age in years/mean age ± SD

Period on ART

Attrition rate

Intervention

Number allocated

Lost to follow-up (died)

Period of intervention

Outcome measure

Outcome tool

Theories and models of behaviour change used or adopted

Conclusion

Gross et al. (2019). [23]

Multinational:

Brazil

Haiti

India

Kenya

Malawi

South Africa

Thailand

Uganda

Zimbabwe

N = 521

Male (272); female (249)

Age: ≥ 18 years

Has previously taken and had resistance to NRTI or NNRTI, who were currently accessing a second-line protease inhibitor-containing

Regimen, which they had been on for at least 24 weeks with no previous darunavir or etravirine exposure

Attrition rate = NR

G1: mobile text reminders (SMS reminder and flashback system once daily for 8 weeks, thrice weekly for another 8 weeks and then once weekly till the 48th week)

Number allocated to g1: 257

The number lost to follow-up: 8 (11 died)

G0: standard of care adherence support

Number allocated to g0: 264

The number lost to follow-up: 12 (12 died)

48 weeks

Medication adherence

Self-report adherence questionnaire

NR

Two-way adherence intervention did not show any clinically relevant benefit

Ruan et al. (2017) [20]

China

N = 100

Male (59); female (41)

Age: ≥ 18 years

Has been on ART for not more than 3 months

Attrition rate = NR

G1: mobile text reminder (SMS for 6 months + usual care)

Number allocated to g1: 50

The number lost to follow-up: 3 (2 death and 1 withdrawal)

G0: usual care which includes: regular health education in the clinic including informational pamphlets, psychological support and personalized health education from nurses and physicians)

Number allocated to g0: 50

The number lost to follow-up: 3 (1 withdrawal)

6 months

Medication adherence

CPCRA adherence self-report questionnaire

VAS on a 100- point scale

Starks et al.’s 3-steps adherence model (centres on 3 steps: step 1- knowledge, step 2- motivation, step 3-proximal cue to action = medication adherence). The SMS intervention was developed based on this model

SMS showed significant efficacy in improving adherence to ART medication in people living with HIV

Nsagha et al. (2016) [26]

Cameroon

N = 90

Male (35); female (55)

Age: ≥ 18 years

Has been on for at least 1 month

Attrition rate = NR

G1: mobile text reminder (standard treatment and care + 4 times weekly educative SMS for 4 weeks)

Number allocated to g1: 45

The number lost to follow-up: NR

G0: standard treatment and care

Number allocated to g0: 45

The number lost to follow-up: NR

1 month

Medication adherence

Self- reported using an interviewer-administered questionnaire

NR

SMS significantly improved adherence to an antiretroviral, a key constraint that affects adherence to antiretroviral medication

Sabin et al. (2015) [27]

China

N = 119

Male (76); female (43)

Age: ≥ 18 years

Has been receiving or initiating ART for the first time

Attrition rate = NR

G1: (comprised of suboptimal adherence group < 90% medication adherence and optimal adherence group > 90% medication adherence) received, real-time SMS reminder triggered by a 30 min delay in medication + adherence counselling

Number allocated to g1: 63

The number lost to follow-up: 1

G0: (comprised of suboptimal adherence group < 90% medication adherence and optimal adherence group > 90% medication adherence) received, usual care + adherence counselling

Number allocated to g0: 56

The number lost to follow-up: 2

6 months

Medication adherence

Wise-pill device

NR

The use of triggered SMS reminders significantly improved antiretroviral therapy adherence in the HIV population

Moore et al. (2014) [24]

USA

N = 58

Male (44); female (6)

The gender of 8 participants who were not included in the analysis was not reported

Age: ≥ 18

Has been on ART, period not specified

Attrition rate = NR

G1: psychoeducation + daily text message medication reminder and mood inquiries for 30 days

Number allocated to g1: 30

The number lost to follow-up: 0

G0: standard of care adherence psychoeducation and daily text mood inquiries

Number allocated to g0: 28

The number lost to follow-up: 2

30 days

Medication adherence

MEMS

Self-reported adherence using VAS

Theory of planned behaviour which posits

That behaviour is driven by behavioural intentions and that

Individual motivational factors interact with cognitive

Impairment, mood disruption, and substance use to create

Both intentional and unintentional nonadherence. The SMS intervention was constructed based on this theory

Daily contact via text messaging is feasible even in difficult populations. Text messaging in conjunction with psychoeducation improves ART doses timing in a group of individuals who are at high risk for nonadherence to important medications (ART)

Both groups showed high levels of overall 30-day MEMS adherence but did not significantly differ for ARV medication adherence

Maduka and Tobin-West., (2013) [22]

Nigeria

N = 104

Male (45); female (59)

Age: ≥ 20

Has been on HAART for at least 3 months before enrollment

Attrition rate = NR

G1: adherence counselling (one-on-one monthly for 4 months) and text message reminder (twice weekly for 4 months) via an internet-based bulk

SMS facility—‘light edge SMS’ powered by light edge systems

Number allocated to g1: 52

The number lost to follow-up: 2

G0: standard care

Number allocated to g0: 52

The number lost to follow-up: 8

4 months

Medication adherence

Self-reported adherence questionnaire

NR

A combination of counselling and text message reminders significantly improved drug adherence among non-adherent HIV patients on HAART

Mbuagbaw et al. (2012) [21]

Cameroon

N = 200

Male (53); female (147)

Age: ≥ 21 years

Has been on ART for at least 1 month

Attrition rate = NR

G1: mobile text reminder (motivational SMS; weekly for 6 months + usual care)

Number allocated to g1: 101

The number lost to follow-up before phone prompt: 59

The number lost to follow-up after phone prompt: 21

G0: usual care (regular ART counselling and home visits)

Number allocated to g0: 99

The number lost to follow-up before phone prompt:57

The number lost to follow-up after phone prompt: 21

6 months

Medication adherence

Quality of life

VAS

Self-report

Pharmacy refill data

SF-12 QOL assessment form

Health belief model. The SMS intervention was designed based on a focus group discussion and this model

There was no significant improvement in the quality of life nor adherence to ART after 6 months of SMS intervention

However, sensitivity analysis showed a slight improvement in medication adherence in the intervention group compared to the control group

da costa et al. (2012) [18]

Brazil

N = 29

Male (0); female (29)

Age: 34.62 ± 6.92

Patients on first or second ART regimen

Attrition rate = NR

G1: mobile text reminder (SMS messages; 5 times a week for 4 months)

Number allocated to g1: 14

The number lost to follow-up: 1

(5 participants did not receive allocated intervention)

G0: no SMS intervention

Number allocated to g0: 15

The number lost to follow-up: 2

4 months

Medication adherence

Self-reported adherence questionnaire

Pill counting

MEM

NR

No significant change in the three outcome measures for medication adherence was reported

However, the intervention stimulated more participants in the intervention group to be adherent to their treatment for at least 4 months of the study period

Pop-eleches et al. (2011) [25]

Kenya

N = 431

Male (148); female (280)

The gender of 3 participants who were not included in the analysis due to faulty MEMS were not reported

Age: > 18 years

Initiated ART for less than 3 months before enrollment

Attrition rate = NR

G1: mobile text reminder (SMS; either short or long messages at daily or weekly frequency for 48 weeks)

The number of patients excluded due to faulty MEMS: 3

Number allocated to short daily messages: 70

The number lost to follow-up: 18.6%

Number allocated to long daily messages: 72

The number lost to follow-up: 16.7%

Number allocated to short weekly messages: 72

The number lost to follow-up: 22%

Number allocated to long weekly messages:74

The number lost to follow-up: 10.8%

G0: no intervention

Number allocated to g0: 139

The number lost to follow-up: 14.4%

48 weeks

Medication adherence

Medication event monitoring system (MEMS)

NR

There was a significant change due to the intervention on the participants who received weekly SMS reminders but no significant change was found in those participants who received daily SMS reminders nor the control group

Lester et al. (2010) [19]

Kenya

N = 538

Male (187); female (351)

Age: > 18 years

Initiating ART for the first time

Attrition rate = 21%

G1: mobile text reminder (SMS support service; weekly for 12 months)

Number allocated to g1: 273

The number lost to follow-up: 17

G0: standard care

Number allocated to g0: 265

The number lost to follow-up: 27

12 months

Medication adherence

Self-reported adherence questionnaire

NR

SMS intervention in PLWH significantly improved adherence to ART compared to patients who received the standard care alone

  1. AR attrition rate, ART antiretroviral therapy, CPCRA Community Programs for Clinical Research on Aids, G1 intervention group, G0 control group, MEMS medication event monitoring system, MEM micro-electronic monitors, NR not reported, NRTI nucleoside analogue reverse transcriptase inhibitors, NNRTI non-nucleoside reverse transcriptase inhibitors, SMS short message services, SD standard deviation, SF-12 QOL Short Form-12 Quality of Life Assessment Form, VAS visual analogue scale