Patient and provider perspectives on cellular phone-based technology to improve HIV treatment adherence

• Published in: AIDS care Vol. 26; no. 1; pp. 26 - 32
• Main Authors: Baranoski, Amy S., Meuser, Elizabeth, Hardy, Helene, Closson, Elizabeth F., Mimiaga, Matthew J., Safren, Steven A., Virk, Pushwaz, Luk, Rowena, Skolnik, Paul R., Kumar, Vikram S.
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 02.01.2014; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Adherence; Adult; AIDS/HIV; Anti-HIV Agents - therapeutic use; Antiretroviral drugs; Antiretroviral therapy; Attitude of Health Personnel; Biological and medical sciences; Cell Phone; Confidentiality; Drug therapy; Female; Health behavior; Health promotion; Health Promotion - methods; HIV; HIV Infections - drug therapy; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Massachusetts; Medical sciences; Medical treatment; Medication Adherence; Patients; Perception; Qualitative Research; Reminder Systems; Reminders; Self Care; Technology; Text Messaging; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Social environment; Human; Immunopathology; Mobile phone; Antiretroviral agent; adherence; antiretroviral therapy; Mental health; Retroviridae; Pharmacotherapy; AIDS; technology; Immune deficiency; Lentivirus; Adhesion; Infection; Virus; Treatment; HIV; Viral disease; Antiviral; Treatment compliance; Human immunodeficiency virus; Public health
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2013.802282

Innovative techniques, potentially using technology, to improve adherence to antiretroviral therapy (ART) may help patients with HIV who struggle with self-care. This qualitative study compared patient and provider participants' perspectives on ART adherence and text messaging as a tool to promote adherence. Thirteen providers and 14 HIV-infected patients identified four main themes: (1) facilitators, (2) barriers to using text message reminders as a medium for ART medication reminders, (3) framing of text message reminders, and (4) patient responsibility and autonomy in the management of their health and wellness. Ease of use, access, convenience, and confidentiality were cited as benefits of a text message-based adherence intervention; while access, cost, difficulty manipulating cellular phones, lack of knowledge/education, and confidentiality were cited as potential barriers. Providers, but not patients, also identified patient apathy and time burden as potential barriers to a text message-based adherence reminder system. Patients and providers felt that personalization of messages, attention to timing, and confidentiality of messages were key factors for a successful text message-based adherence reminder system. Both providers and patients felt that patient responsibility and autonomy over an individual's own health care is an important issue in adherence to medical care. The majority of patients and providers felt that a text message-based adherence reminder system would be beneficial. While patients and providers had many similar views on factors influencing adherence with ART and the use of text messaging to improve adherence, there were some divergent views between the two groups.