Use of the telephone for accessing people living with HIV/AIDS to antiretroviral therapy: systematic review

Santos, Vanessa da Frota; Costa, Ana Karoline Bastos; Lima, Ivana Cristina Vieira de; Alexandre, Herta de Oliveira; Gir, Elucir; Galvão, Marli Teresinha Gimeniz

doi:10.1590/1413-81232018249.31112017

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REVIEW • Ciênc. saúde coletiva 24 (9) • Sept 2019 • https://doi.org/10.1590/1413-81232018249.31112017 copy

Use of the telephone for accessing people living with HIV/AIDS to antiretroviral therapy: systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This paper aims to evaluate the effectiveness of telephone use for the adherence of people with HIV/AIDS to antiretroviral therapy. A systematic review was carried out in the following databases: Latin American and Caribbean Literature in Health Sciences (Lilacs/ Bireme), SCOPUS, Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science; and in the Scientific Electronic Library Online (SciELO) and Cochrane libraries, using the following descriptors: “HIV”, “Cell Phones”, “Acquired Immunodeficiency Syndrome” and “Antiretroviral Therapy, Highly Active”. We gathered a sample of 17 papers. The proposed cellphone interventions were the use of cellular applications, Short Message Service, and telephone calls. In most studies, telephone use has had a significant impact on adherence to treatment. The evaluation of the studies showed good methodological quality and adequate allocation secrecy. Self-reported adherence emerged among the adherence measuring methods. Cellphone use was effective in improving adherence to antiretroviral therapy for people living with HIV.

Key words
HIV; Acquired Immunodeficiency Syndrome; Cell phones

Authors, year, country	Intervention employed	Sample	Follow-up time	Results
Hardy et al. (2011), EUA⁷7 Hardy H, Kumar V, Doros G, Farmer E, Drainoni ML, Rybin D, Myung D, Jackson J, Backman E, Stanic A, Skolnik PR. Randomized controlled trial of a personalized cellular phone reminder system to enhance adherence to antiretroviral therapy. AIDS Patient Care STDs 2011; 25(3):153-161.	^* * SMS: Short Message Service SMS	23 ^ IG: Intervention Group; IG: 10/ ^* ***** CG: Control Group; CG: 9	6 weeks	The mean adherence was 79% through self-report and 65% by counting tablets at the onset of the study in both groups. Over 6 weeks, adherence increased in the IG concerning: tablet count [^** **** M: mean; M:76.3% ± ^* * SD: Standard Deviation; SD: 20.5], self-report [M: 83.1% ± SD: 26.2], ^** **** DEM: Drug Event Monitoring; DEM [M: 73.9% ± SD: 27.3] and composite adherence score [M: 70.6% ± SD: 24.8]
Lester et al. (2010), Quênia⁸8 Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M, Marra CA, Estambale B, Ngugi E, Ball T, Thabane L, Gelmon LJ, Kimani J, Ackers M, Plummer FA. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1):a randomised trial. The Lancet 2010; 376 (9755):1838-1845.	SMS	538 IG: 273/CG: 265	48 weeks	Adherence was reported by 168 of the 273 patients of the IG compared to 132 of the 265 of the CG (^***** *** RR: Relative Risk; RR for non-adherence = 0.81; ^**** **** CI: Confidence Interval; [95% CI=0.69-0.94; ^***** ******* p: p-value; p=0.006)
Pop-Eleches et al. (2011), Quênia⁹9 Pop-eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, DeWalque D, MacKeen L, Haberer J, Kimaiyo S, Sidle J, Ngare D, Bangsberg DR. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011; 25(6):825-834.	SMS	431 IG: 302/CG:139	48 weeks	90% IG adherence compared to 40% CG adherence (p=0.03)
Maduka; Tobin-West (2013), Nigéria¹⁰10 Maduka O, Tobin-West CI. Adherence counseling and reminder text messages improve uptake of antiretroviral therapy in a tertiary hospital in Nigeria. Niger J Clin Pract 2013; 16(3):302-308.	SMS	104 IG: 52/CG:52	16 weeks	76.9% of the patients in the IG adhered to the drug treatment as opposed to 55.8% in the CG (p=0.022). The IG CD4 + lymphocyte count increased to 578.0 cells/ml compared to 361.5 cells/ml recorded in the CG (p=0.007)
Dowshen et al. (2012), EUA¹⁷17 Dowshen N, Kuhns LM, Johnson A, Holoyda BJ, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. J Med Internet Res 2012; 14(2):e51.	SMS	25 IG e CG: information not available	24 weeks	Self-reported adherence increased in the IG compared to baseline (74.7) in weeks 12 (93.3) (p<0.001) and 24 (93.1) (p <0.001)
Kalichman et al. (2011), EUA¹⁸18 Kalichman SC, Kalichman MO, Cherry C, Swetzes C, Amaral CM, White D, Jones M, Grebler T, Eaton L. Brief behavioral self-regulation counseling for HIV treatment adherence delivered by cell phone: an initial test of concept trial. AIDS Patient Care STDS 2011; 25(5):303-310.	Telephone calls	40 IG: 21/CG: 19	16 weeks	Adherence was improved in the IG from 87% of the tablets taken at the onset of the intervention to 94% at the end of the intervention (p<0.01)
Belzer et al. (2014), EUA¹⁹19 Belzer ME, Naar-King S, Olson J, Sarr M, Thornton S, Kahana SY, Gaur AH, Clark LF. The use of cell phone support for non-adherent HIV-infected youth and young adults: an initial randomized and controlled intervention trial. AIDS Behav 2014; 18(4):686-696.	Telephone calls	37 IG: 19/CG: 18	24 weeks	Self-reported adherence was higher in IG compared to CG (p=0.007)
Swendeman et al. (2015), EUA²⁰20 Swendeman D, Jana S, Ray P, Mindry D, Das M, Bhakta B. Development and Pilot Testing of Daily Interactive Voice Response (IVR) Calls to Support Antiretroviral Adherence in India: A Mixed-Methods Pilot Study. AIDS Behav 2015; 2(19 Supl.):142-155.	Cellphone application	50 IG: 34/CG: 16	6 weeks	The correlations were relatively high in the IG and CG by including 100% adherence of the participants (^******** ******** r: correlation coefficient; r=0.70-0.73)
Rana et al. (2016), EUA²¹21 Rana AI, Van den Berg JJ, Lamy E, Beckwith CG. Using a Mobile Health Intervention to Support HIV Treatment Adherence and Retention Among Patients at Risk for Disengaging with Care. AIDS Patient Care STDS 2016; 30(4):178-184.	SMS	32 enrolled 20 concluded IG and CG: information not available	24 weeks	18 of the 32 participants had a viral load < 20 copies/ml at the onset of the study, and 25 (78%) participants had viral suppression (< 20 copies/ml, p=0.002)
Garofalo et al. (2016), Chicago²²22 Garofalo R, Kuhns LM, Hotton A, Johnson A, Muldoon A, Rice D. A randomized controlled trial of personalized text message reminders to promote medication adherence among HIV-positive adolescents and young adults. AIDS and Behavior. 2016; 20(5):1049-1059.	SMS	109 IG: 55/CG: 54	48 weeks	The mean adherence between the IG was higher than in the CG (95% CI: 0.91-13.9), and the odds ratio for ≥ 90% adherence was 2.57 (95% CI: 1.01-6.54). Adherence increased from 28% at baseline to 64% at 3 months and slightly decreased to 61% at 6 months' follow-up in the IG, whereas the CG achieved 24% at baseline and 43% and 51% at baseline at 3 and 6 months' follow-up, respectively.
Perera et al. (2014), Uganda²³23 Perera AI, Thomas MG, Moore JO, Faasse K, Petrie KJ. Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: a randomized clinical trial. AIDS Patient Care STDS 2014; 28(11):579-586.	Cellphone application	28 IG: 17/CG: 11	12 weeks	IG showed better adherence (p=0.03) when compared to CG
Orrell et al. (2015), África²⁴24 Orrell C, Cohen K, Mauff K, Bangsberg DR, Maartens G, Wood R. A randomized controlled trial of real-time electronic adherence monitoring with text message dosing reminders in people starting first-line antiretroviral therapy. J Acquir Immune Defic Syndr 2015; 70(5):495-502.	SMS	230 IG: 115/CG: 115	48 weeks	Adherence was 82.1% in the IG compared to 80.4% in the CG [OR: 1.08; 95% CI: 0.77-1.52]
Sabin et al. (2015), China²⁵25 Sabin LL, Bachman DSM, Gill CJ, Zhong L, Vian T, Xie W, Cheng F, Xu K, Lan G, Haberer JE, Bangsberg DR, Li Y, Lu H, Gifford AL. Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders: The China Adherence Through Technology Study. J Acquir Immune Defic Syndr 2015; 69(5):551-559.	SMS	119 IG: 63/CG: 56	24 weeks	Adherence was similar in the two groups, with improved adherence by 52 of the 63 of the IG (82.5%) compared to 29 of the 56 of the CG (51.8%) (RR 1.59; 95% CI: 1.21-2.10 p<0.001)
Shet et al. (2014), India²⁶26 Shet A, De Costa A, Kumarasamy N, Rodrigues R, Rewari BB, Ashorn P, Eriksson B, Diwan V. Effect of mobile telephone reminders on treatment outcome in HIV: evidence from a randomised controlled trial in India. BMJ 2014; 349:g5978.	Telephone calls and SMS	631 IG: 315/CG: 316	96 weeks	Adherence was similar between IG and CG (RR 1.24 [CI=95%] = 0.93-1.65, p= 0.14)
Swendeman et al. (2015), Índia²⁷27 Swendeman D, Comulada WS, Ramanathan N, Lazar M, Estrin D. Reliability and Validity of Daily Self-Monitoring by Smartphone Application for Health-Related Quality-of-Life, Antiretroviral Adherence, Substance Use, and Sexual Behaviors Among People Living with HIV. AIDS Behav 2015; 19(2):330-340.	SMS	90 IG: 46/CG: 44	4 weeks	In the GI, missed doses of medications were reduced from 39% to 18%, and ratios of missed doses fell from 44% to 17%
Abdulrahman et al. (2017), Malásia²⁸28 Abdulrahman SA, Rampal L, Ibrahim F, Radhakrishnan AP, Shahar HK, Othman N. Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial. PloS one 2017; 12(5):e0177698.	SMS and Telephone calls	224 IG: 116/CG: 108	24 weeks	Adherence was higher in the IG (95.7; 95% CI: 94.39-96.97) than in the CG (87.5; 95% CI: 86.14-88.81). An increased CD4 + lymphocyte count (p = 0.017) was found in the IG, and the viral load was higher (p=0.001) in the CG
Costa et al., (2012), Brasil²⁹29 Costa TM, Barbosa BJ, Gomes E, Costa DA, Sigulem D, De Fátima MH, Filho AC, Pisa IT. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages. Int J Med Inform 2012; 81(4):257-269.	SMS	21 IG: 8/CG: 13	20 weeks	The adherence of the participants in the IG was higher than in the CG (tablet counts [50.0% in the IG and 38.4% in CG], self-report [100.0% in the IG and 84.6% in CG], DEM [75.0% in the IG and 46.1% in the CG], but no statistically significant difference was found between the results

Authors, year	Jadad's Scale^* * Classification that evaluates the quality of the study and the score ranges from 0 to 5, and studies of low quality are those with scores lower than 3.	Allocation secrecy^ The allocation secrecy classification is as follows: Category A - allocation secrecy adequately performed and described; Category B - the study was described as random, but there is no description of the randomization type nor of the allocation secrecy; Category C - the allocation secrecy was inappropriate; and Category D - the study was not random.
Hardyet al. (2011)⁷7 Hardy H, Kumar V, Doros G, Farmer E, Drainoni ML, Rybin D, Myung D, Jackson J, Backman E, Stanic A, Skolnik PR. Randomized controlled trial of a personalized cellular phone reminder system to enhance adherence to antiretroviral therapy. AIDS Patient Care STDs 2011; 25(3):153-161.	3	B
Lester et al. (2010)⁸8 Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M, Marra CA, Estambale B, Ngugi E, Ball T, Thabane L, Gelmon LJ, Kimani J, Ackers M, Plummer FA. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1):a randomised trial. The Lancet 2010; 376 (9755):1838-1845.	3	A
Pop-Eleches et al. (2011)⁹9 Pop-eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, DeWalque D, MacKeen L, Haberer J, Kimaiyo S, Sidle J, Ngare D, Bangsberg DR. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS 2011; 25(6):825-834.	4	B
Maduka; Tobin-West (2013)¹⁰10 Maduka O, Tobin-West CI. Adherence counseling and reminder text messages improve uptake of antiretroviral therapy in a tertiary hospital in Nigeria. Niger J Clin Pract 2013; 16(3):302-308.	4	A
Dowshen et al. (2012)¹⁷17 Dowshen N, Kuhns LM, Johnson A, Holoyda BJ, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. J Med Internet Res 2012; 14(2):e51.	1	D
Kalichman et al. (2011)¹⁸18 Kalichman SC, Kalichman MO, Cherry C, Swetzes C, Amaral CM, White D, Jones M, Grebler T, Eaton L. Brief behavioral self-regulation counseling for HIV treatment adherence delivered by cell phone: an initial test of concept trial. AIDS Patient Care STDS 2011; 25(5):303-310.	5	A
Belzer et al. (2014)¹⁹19 Belzer ME, Naar-King S, Olson J, Sarr M, Thornton S, Kahana SY, Gaur AH, Clark LF. The use of cell phone support for non-adherent HIV-infected youth and young adults: an initial randomized and controlled intervention trial. AIDS Behav 2014; 18(4):686-696.	4	B
Swendeman et al. (2015)²⁰20 Swendeman D, Jana S, Ray P, Mindry D, Das M, Bhakta B. Development and Pilot Testing of Daily Interactive Voice Response (IVR) Calls to Support Antiretroviral Adherence in India: A Mixed-Methods Pilot Study. AIDS Behav 2015; 2(19 Supl.):142-155.	4	B
Rana et al. (2016)²¹21 Rana AI, Van den Berg JJ, Lamy E, Beckwith CG. Using a Mobile Health Intervention to Support HIV Treatment Adherence and Retention Among Patients at Risk for Disengaging with Care. AIDS Patient Care STDS 2016; 30(4):178-184.	3	A
Garofalo et al. (2016)²²22 Garofalo R, Kuhns LM, Hotton A, Johnson A, Muldoon A, Rice D. A randomized controlled trial of personalized text message reminders to promote medication adherence among HIV-positive adolescents and young adults. AIDS and Behavior. 2016; 20(5):1049-1059.	5	A
Perera et al. (2014)²³23 Perera AI, Thomas MG, Moore JO, Faasse K, Petrie KJ. Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: a randomized clinical trial. AIDS Patient Care STDS 2014; 28(11):579-586.	3	A
Orrell et al. (2015)²⁴24 Orrell C, Cohen K, Mauff K, Bangsberg DR, Maartens G, Wood R. A randomized controlled trial of real-time electronic adherence monitoring with text message dosing reminders in people starting first-line antiretroviral therapy. J Acquir Immune Defic Syndr 2015; 70(5):495-502.	5	A
Sabin et al. (2015)²⁵25 Sabin LL, Bachman DSM, Gill CJ, Zhong L, Vian T, Xie W, Cheng F, Xu K, Lan G, Haberer JE, Bangsberg DR, Li Y, Lu H, Gifford AL. Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders: The China Adherence Through Technology Study. J Acquir Immune Defic Syndr 2015; 69(5):551-559.	5	A
Shet et al. (2014)²⁶26 Shet A, De Costa A, Kumarasamy N, Rodrigues R, Rewari BB, Ashorn P, Eriksson B, Diwan V. Effect of mobile telephone reminders on treatment outcome in HIV: evidence from a randomised controlled trial in India. BMJ 2014; 349:g5978.	4	A
Swendeman et al. (2015)²⁷27 Swendeman D, Comulada WS, Ramanathan N, Lazar M, Estrin D. Reliability and Validity of Daily Self-Monitoring by Smartphone Application for Health-Related Quality-of-Life, Antiretroviral Adherence, Substance Use, and Sexual Behaviors Among People Living with HIV. AIDS Behav 2015; 19(2):330-340.	1	D
Abdulrahman et al. (2017)²⁸28 Abdulrahman SA, Rampal L, Ibrahim F, Radhakrishnan AP, Shahar HK, Othman N. Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial. PloS one 2017; 12(5):e0177698.	5	A
Costa et al., (2012)²⁹29 Costa TM, Barbosa BJ, Gomes E, Costa DA, Sigulem D, De Fátima MH, Filho AC, Pisa IT. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages. Int J Med Inform 2012; 81(4):257-269.	5	A

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[1] Collaborations

VF Santos, AKB Costa, ICV Lima and HO Alexandre: Conception and design, collection, analysis, interpretation of data and active participation in the discussion of results. Writing of the article or relevant critical review of the intellectual content. Compliance with all aspects of the manuscript in terms of the accuracy or completeness of the information. MTG Galvão and E Gir: Review and final approval of the version to be published. Compliance with all aspects of the manuscript in terms of the accuracy or completeness of the information. VF Santos and AKB Costa: Review and final approval of the version to be published.