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A Randomized Controlled Trial of Personalized Text Message Reminders to Promote Medication Adherence Among HIV-Positive Adolescents and Young Adults

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Abstract

HIV-positive adolescents and young adults often experience suboptimal medication adherence, yet few interventions to improve adherence in this group have shown evidence of efficacy. We conducted a randomized trial of a two-way, personalized daily text messaging intervention to improve adherence to antiretroviral therapy (ART) among N = 105 poorly adherent HIV-positive adolescents and young adults, ages 16–29. Adherence to ART was assessed via self-reported visual analogue scale (VAS; 0–100 %) at 3 and 6-months for mean adherence level and proportion ≥90 % adherent. The average effect estimate over the 6-month intervention period was significant for ≥90 % adherence (OR = 2.12, 95 % CI 1.01–4.45, p < .05) and maintained at 12-months (6 months post-intervention). Satisfaction scores for the intervention were very high. These results suggest both feasibility and initial efficacy of this approach. Given study limitations, additional testing of this intervention as part of a larger clinical trial with objective and/or clinical outcome measures of adherence is warranted.

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Acknowledgments

We thank the participants of the “TXTXT” study for their time and effort. Special thanks to Camdin Gray and Jennifer Leininger for their contributions to sample recruitment and retention. Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R34DA031053. Additional support was received from the Stanley Manne Children’s Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago (Lurie Children’s). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Approval to conduct this study was received from the Institutional Review Board (IRB) at Lurie Children’s under protocol #2011-14398. Drs. Garofalo and Kuhns jointly developed the study rationale, aims, and design. Dr. Garofalo supervised the implementation of the study and drafted and revised the final manuscript. Dr. Kuhns drafted the methods section, assisted with interpretation of findings, and critically reviewed the manuscript. Dr. Hotton conducted all data analyses, created all tables, drafted the statistical methods and results sections, and critically reviewed the manuscript. Ms. Johnson and Ms. Muldoon oversaw data entry and data quality and critically reviewed the manuscript; additionally Ms. Muldoon drafted Fig. 1. Mr. Rice assisted with the background literature review and critically reviewed the final manuscript. All authors approved the final manuscript as submitted.

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Authors and Affiliations

  1. Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA

    Robert Garofalo, Lisa M. Kuhns, Amy Johnson, Abigail Muldoon & Dion Rice

  2. Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Robert Garofalo & Lisa M. Kuhns

  3. Division of Infectious Diseases, John H. Stroger Hospital of Cook County, Chicago, IL, USA

    Anna Hotton

  4. AIDS Foundation of Chicago, Chicago, IL, USA

    Amy Johnson

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  1. Robert Garofalo
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  6. Dion Rice
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Correspondence to Robert Garofalo.

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Additional information

Clinical trials registration: This trial has been registered at www.clinicaltrials.gov (identifier NCT01354210).

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Garofalo, R., Kuhns, L.M., Hotton, A. et al. A Randomized Controlled Trial of Personalized Text Message Reminders to Promote Medication Adherence Among HIV-Positive Adolescents and Young Adults. AIDS Behav 20, 1049–1059 (2016). https://doi.org/10.1007/s10461-015-1192-x

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  • DOI: https://doi.org/10.1007/s10461-015-1192-x

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