Development of a digital pill and respondent behavioral intervention (PrEPSteps) for HIV pre-exposure prophylaxis adherence among stimulant using men who have sex with men

Chai, Peter R; Mohamed, Yassir A.; Goodman, Georgia R; Bustamante, María José; Sullivan, Matthew C.; Najarro, Jesse; Mendez, Lizette; Mayer, Kenneth H.; Boyer, Edward W.; O’Cleirigh, Conall; Rosen, Rochelle K.

doi:10.1093/tbm/ibab117

Cited by 10 publications

(8 citation statements)

References 40 publications

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“…In this investigation and in prior qualitative work among MSM [9], participants responded positively to the prospect of messaging modules linked to the DPS, and noted that integrated reminder messages would have the potential to help reinforce users' commitment to maintaining PrEP adherence. These modules could be simple text message systems that serve as reminders that can be triggered when nonadherence is detected by a DPS, or more in-depth bidirectional messages that center the conversation of PrEP adherence around objective measures of ingestion [22,23].…”

Section: Discussionmentioning

confidence: 99%

Real-World User Experiences with a Digital Pill System to Measure PrEP Adherence: Perspectives from MSM with Substance Use

et al. 2022

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Once-daily oral pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV transmission, but adherence can be challenging for men who have sex with men (MSM) who use substances. A novel method for directly measuring ingestion events is a digital pill system (DPS), which comprises an ingestible radiofrequency emitter that signals a wearable Reader device upon PrEP ingestion, relaying ingestion data to a wearable Reader device and then to a smartphone application. Qualitative interviews were conducted with 15 MSM with non-alcohol substance use following an open-label pilot demonstration trial involving use of the DPS to measure PrEP adherence for 90 days. The purpose of this qualitative investigation was to understand overall user experiences and potential barriers and facilitators to using the DPS to measure PrEP adherence among MSM. The DPS was largely perceived as acceptable, novel, and valuable, with most participants reporting that the system was easily integrated into their daily routines. Technological and design factors, especially related to the wearable Reader, impacted participants' interest in using the technology long-term; several suggested improvements were discussed. Trial Registration ClinicalTrials.gov: NCT03842436.

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Section: Discussionmentioning

confidence: 99%

Real-World User Experiences with a Digital Pill System to Measure PrEP Adherence: Perspectives from MSM with Substance Use

et al. 2022

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“…HIV pre-exposure prophylaxis), researchers should incorporate key cultural underpinnings of adherence monitoring in India, as well as mobile phone literacy, which may de ne both the platform and content of ATT adherence interventions in India. [22,23] There are several limitations in this study. First, due to the pilot nature of this study, the sample was small and primarily located in Kerala, India.…”

Section: Discussionmentioning

confidence: 95%

Formative acceptance of ingestible biosensors to measure adherence to TB medications: An exploratory study

Vaz

Jose

Tom

et al. 2022

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Background: Tuberculosis (TB) represents a significant public health threat in India. Adherence to antitubercular therapy (ATT) is the key to reducing the burden of this infectious disease. Suboptimal adherence to ATT and lack of demonstrated feasibility of current strategies for monitoring ATT adherence highlights the need for alternative adherence monitoring systems.Methods: A quantitative survey was conducted to assess the acceptance of and willingness to use a digital pill system (DPS) as a tool for monitoring ATT adherence among stakeholders directly involved in the management of patients with TB in India. Participants reviewed a video explaining the DPS and completed a survey, which covered sociodemographics, degree of involvement with TB patients, initial impressions of the DPS, and perceived challenges for deploying the technology in India. Participants were also asked to interpret mock DPS adherence data.Results: The mean age was 34.3 (SD=7.3), and participants (N=50) were predominantly male (70%). The sample comprised internists (52%) and pulmonologists (30%), with a median of four years’ experience (IQR 3,6) in the management of TB patients. No participants had previously used a DPS, but some reported prior awareness of the technology (22%). Most reported that they would recommend use of a DPS to patients on ATT (76%), and that they would use a DPS in both the intensive and continuation phases of TB management (64%). The majority viewed the DPS (82%) as a useful alternative to directly observed therapy-short course (DOTS), particularly given the ongoing COVID-19 pandemic. Participants reported that a DPS would be most effective in patients at risk of nonadherence (64%), as well as those with past nonadherence (64%). Perceived barriers to DPS implementation included lack of patient willingness (92%), cost (86%), and infrastructure constraints (66%). The majority of participants were able to accurately interpret patterns of adherence (80%), suboptimal adherence (90%), and frank nonadherence (82%) when provided with mock DPS data.Conclusions: DPS are viewed as an acceptable, feasible, and useful technology for monitoring ATT adherence by stakeholders directly involved in TB management. Future investigations should explore patient acceptance of DPS and pilot demonstration of the system in the TB context.

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“…Additionally, given the finding that clinicians can use DPS data to make management decisions around ATT adherence monitoring, future research should explore the specification and design of ATT interventions that are built around real-time DPS adherence data. While previous work has developed smartphone-based reminder systems and personalized adherence interventions that are delivered in response to DPS data for other diseases (e.g., HIV pre-exposure prophylaxis), researchers should incorporate key cultural underpinnings of adherence monitoring in India, as well as mobile phone literacy, which may define both the platform and content of ATT adherence interventions in India [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Formative acceptance of ingestible biosensors to measure adherence to TB medications

et al. 2022

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Background Tuberculosis (TB) represents a significant public health threat in India. Adherence to antitubercular therapy (ATT) is the key to reducing the burden of this infectious disease. Suboptimal adherence to ATT and lack of demonstrated feasibility of current strategies for monitoring ATT adherence highlights the need for alternative adherence monitoring systems. Methods A quantitative survey was conducted to assess the acceptance of and willingness to use a digital pill system (DPS) as a tool for monitoring ATT adherence among stakeholders directly involved in the management of patients with TB in India. Participants reviewed a video explaining the DPS and completed a survey, which covered sociodemographics, degree of involvement with TB patients, initial impressions of the DPS, and perceived challenges for deploying the technology in India. Participants were also asked to interpret mock DPS adherence data. Results The mean age was 34.3 (SD = 7.3), and participants (N = 50) were predominantly male (70%). The sample comprised internists (52%) and pulmonologists (30%), with a median of 4 years’ experience (IQR 3, 6) in the management of TB patients. No participants had previously used a DPS, but some reported prior awareness of the technology (22%). Most reported that they would recommend use of a DPS to patients on ATT (76%), and that they would use a DPS in both the intensive and continuation phases of TB management (64%). The majority viewed the DPS (82%) as a useful alternative to directly observed therapy-short course (DOTS), particularly given the ongoing COVID-19 pandemic. Participants reported that a DPS would be most effective in patients at risk of nonadherence (64%), as well as those with past nonadherence (64%). Perceived barriers to DPS implementation included lack of patient willingness (92%), cost (86%), and infrastructure constraints (66%). The majority of participants were able to accurately interpret patterns of adherence (80%), suboptimal adherence (90%), and frank nonadherence (82%) when provided with mock DPS data. Conclusions DPS are viewed as an acceptable, feasible, and useful technology for monitoring ATT adherence by stakeholders directly involved in TB management. Future investigations should explore patient acceptance of DPS and pilot demonstration of the system in the TB context.

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Development of a digital pill and respondent behavioral intervention (PrEPSteps) for HIV pre-exposure prophylaxis adherence among stimulant using men who have sex with men

Cited by 10 publications

References 40 publications

Real-World User Experiences with a Digital Pill System to Measure PrEP Adherence: Perspectives from MSM with Substance Use

Real-World User Experiences with a Digital Pill System to Measure PrEP Adherence: Perspectives from MSM with Substance Use

Formative acceptance of ingestible biosensors to measure adherence to TB medications: An exploratory study

Formative acceptance of ingestible biosensors to measure adherence to TB medications

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