November 22, 2022
2 min read
Cummings reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.
An intervention using weekly phone reminders may be an effective method to increase adherence to antiretroviral therapy and reduce morbidity among patients with HIV, according to research presented at ID Week 2022.
“Regardless of the underlying causes, it’s been shown that maintenance of adequate ART adherence decreases progression of HIV to AIDS,” Bailey Cummings, a medical student at the University of Arkansas for Medical Sciences College of Medicine, said during the presentation. “And improved levels of ART adherence with suppression of the HIV viral load, and a consistently suppressed viral load leads to reduced disease transmission and overall decreased morbidity and mortality among patients with HIV.”
Cummings and colleagues developed an intervention in which patients with a history of poor ART adherence received phone calls or text messages weekly to assess their medication adherence and to encourage them to continue taking their medication.
They enrolled 22 patients who received calls and texts for 6 months and then were followed for another 6 months. The researchers compared adherence during the intervention period and during a 12-month pre-intervention period.
The researchers assessed patients’ viral load, CD4 counts, clinic visits, ED visits, hospitalizations and new-onset opportunistic infections during the preintervention and intervention periods.
Of all 22 patients enrolled, the intervention led to an increase in mean annual clinic visits (2.6 vs. 3.8), decreased median viral load (32,979 vs. 852 copies/mL, P = 0.017), and increased median CD4 (142.5 vs 249 cells/uL) compared with the pre-intervention period.
The intervention also led to a decrease in the number of patients with one or more ED visits (54.6% vs. 36.4%), one or more hospitalizations (36.4% vs. 13.6%), and new-onset opportunistic infection (18.2% vs. 13.6%).
Among the 22 patients enrolled, 13 (55%) had consistent communication during the entire intervention period. During the intervention period, these patients had greater improvements in mean annual clinic visits (2.9 vs. 5.2), mean viral load (27,633 vs. 118 copies/mL, P = 0.0248), CD4 (76 vs. 253 cells/uL), one or more ED visits (61.5% vs. 30.8%), one or more hospitalizations (38.5% vs. 23.1%) and opportunistic infection (23.1% vs. 7.7 %).
“From these results, we can see that persistent communication from mobile phone reminders may serve as a useful tool in an outpatient setting to improve ART adherence and to reduce morbidity among adults with HIV,” Cummings and colleagues wrote. “Overall, findings from the small pilot study provide support for the need to conduct a larger study in order to prove the benefit of this care model.”