A Randomized Controlled Trial Comparing the Effects of Counseling and Alarm Device on HAART Adherence and Virologic Outcomes

Chung, Michael H.; Richardson, Barbra A.; Tapia, Kenneth; Benki-Nugent, Sarah; Kiarie, James; Simoni, Jane M.; Overbaugh, Julie; Attwa, Mena; John‐Stewart, Grace

doi:10.1371/journal.pmed.1000422

Cited by 101 publications

(121 citation statements)

References 48 publications

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“…38,39 The current review included studies with objective measures of adherence, large proportion of black subjects, wider range of follow-up and studies with repeated measures of adherence that allowed evaluating a possible dose effect. 45 Our study has several limitations. First, most of the studies recruited black populations preferentially, and the percentage of studies focusing on non-minority subjects was low.…”

Section: Discussionmentioning

confidence: 91%

Motivational Interviewing Improves Medication Adherence: a Systematic Review and Meta-analysis

et al. 2016

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BACKGROUND: Randomized clinical trials (RCTs), mostly conducted among minority populations, have reported that motivational interviewing (MI) can improve medication adherence. OBJECTIVES: To evaluate the impact of MI and of the MI delivery format, fidelity assessment, fidelity-based feedback, counselors' background and MI exposure time on adherence. DATA SOURCES: We searched the MEDLINE database for studies published from 1966 until February 2015. STUDY ELIGIBILITY CRITERIA: We included RCTs that compared MI to a control group and reported a numerical measure of medication adherence. DATA SYNTHESIS: The main outcome was medication adherence defined as any subjective or objective measure reported as the proportion of subjects with adequate adherence or mean adherence and standard deviation. For categorical variables we calculated the relative risk (RR) of medication adherence, and for continuous variables we calculated the standardized mean difference (SMD) between the MI and control groups. RESULTS: We included 17 RCTs. Ten targeted adherence to HAART. For studies reporting a categorical measure (n = 11), the pooled RR for medication adherence was higher for MI compared with control (1.17; 95 % CI 1.05-1.31; p < 0.01). For studies reporting a continuous measure (n = 11), the pooled SMD for medication adherence was positive (0.70; 95 % CI 0.15-1.25; p < 0.01) for MI compared with control. The characteristics that were significantly (p < 0.05) associated with medication adherence were telephonic MI and fidelity-based feedback among studies reporting categorical measures, group MI and fidelity assessment among studies reporting continuous measures and delivery by nurses or research assistants. Effect sizes differed in magnitude, creating high heterogeneity. CONCLUSION: MI improves medication adherence at different exposure times and counselors' educational level. However, the evaluation of MI characteristics associated with success had inconsistent results. Larger studies targeting diverse populations with a variety of chronic conditions are needed to clarify the effect of different MI delivery modes, fidelity assessment and provision of fidelity based-feedback.KEY WORDS: adherence; behavioral medicine; patient engagement.

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Section: Discussionmentioning

confidence: 91%

Motivational Interviewing Improves Medication Adherence: a Systematic Review and Meta-analysis

et al. 2016

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“…The effects of interventions are summarized in Table 1 46,48,54,62,64,[66][67][68]73,81 Details of the latter studies serve to illuminate the most potent interventions among the studies in this review. Chung and colleagues 66 conducted a randomized controlled factorial design trial in 361 treatment naïve HIV-infected adults in Nairobi, Kenya initiating ART.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Chung and colleagues 66 conducted a randomized controlled factorial design trial in 361 treatment naïve HIV-infected adults in Nairobi, Kenya initiating ART. The participants were randomized to one of four arms: counselling (three counselling sessions around ART initiation), alarm (pocket electronic pill reminder carried for 6 months), counselling plus alarm, and a control arm (neither counselling nor alarm).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Five of the 33 interventions (15%) tested in high income settings were successful, 46 48,54,62,64 compared to four of eleven (36%) in low income settings. [66][67][68]73 Effects by theoretical framework. Five of the 30 (17%) studies with an explicit theoretical framework were successful in improving both adherence and clinical outcomes.…”

Section: Effects Of Interventionsmentioning

confidence: 99%

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Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

Mbuagbaw

Sivaramalingam

Navarro

et al. 2015

AIDS Patient Care and STDs

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We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged.

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“…While the kind and quality of SC was found to vary considerably between studies, their findings indicate that SC for adherence support can be effective [14]. Individual counselling for adherence support has been identified as one of the more common strategies adopted by HIV treatment programmes both in the United States [6] and Africa [15,16]. The content and approach of these interventions varies widely, and the extent to which busy clinics and health care providers are able to effectively incorporate counselling into clinical care is not well established [7].…”

mentioning

confidence: 99%

“It’s Important to Take Your Medication Everyday Okay?” An Evaluation of Counselling by Lay Counsellors for ARV Adherence Support in the Western Cape, South Africa

et al. 2012

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A Randomized Controlled Trial Comparing the Effects of Counseling and Alarm Device on HAART Adherence and Virologic Outcomes

Abstract: Michael Chung and colleagues show that intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and virologic treatment failure, whereas use of an alarm device had no effect.

Cited by 101 publications

References 48 publications

Motivational Interviewing Improves Medication Adherence: a Systematic Review and Meta-analysis

Motivational Interviewing Improves Medication Adherence: a Systematic Review and Meta-analysis

Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies

“It’s Important to Take Your Medication Everyday Okay?” An Evaluation of Counselling by Lay Counsellors for ARV Adherence Support in the Western Cape, South Africa

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