Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: Results from a randomized trial

Peltzer, Karl; Ramlagan, Shandir; Jones, Deborah L.; Fomundam, Henry; Chanetsa, Lucia

doi:10.1080/17290376.2012.745640

Cited by 41 publications

(70 citation statements)

References 34 publications

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“…Together, these described 14 RCTs in our analyses (Table 1). 38, 39, 41–53 Individual level data were available for 9 of the RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…The most common measure reported was the proportion of patients in each arm with at least 95% adherence by self-report; ten studies reported this operationalization. 41–46, 48, 51–53 Four studies reported the proportion of patients with no missed dose or 100% adherence, 41, 46, 47, 53 and two reported the proportion with at least 90% adherence. 49, 50 …”

Section: Resultsmentioning

confidence: 99%

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Interventions to promote adherence to antiretroviral therapy in Africa: a network meta-analysis

Mills¹,

Lester²,

Thorlund³

et al. 2014

The Lancet HIV

107

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Structured Summary Background Adherence to antiretroviral therapy (ART) is a necessary condition to the improvement of HIV patient health and public health through ART. This study sought to determine the comparative effectiveness of different interventions for improving ART adherence among HIV-infected persons living in Africa. Methods We searched for randomized trials that evaluated an intervention to promote antiretroviral adherence within Africa. We created a network of the differing interventions by pooling the published and individual patient data for comparable treatments and comparing them across the individual interventions using Bayesian network meta-analyses. Outcomes included self-reported adherence and viral suppression. Findings We obtained data on 14 randomized controlled trials, involving 7,110 patients. Interventions included daily and weekly short message service (SMS) messaging, calendars, peer supporters, alarms, counseling, and basic and enhanced standard of care (SOC). For self-reported adherence, we found distinguishable improvement in adherence compared to SOC with enhanced SOC (odds ratio [OR]: 1.46, 95% credibility interval [CrI]: 1.06–1.98), weekly SMS messages (OR:1.65; 95% CrI: 1.25–2.18), counseling and SMS combined (OR:2.07; 95% CrI: 1.22–3.53), and treatment supporters (OR:1.83; 95% CrI:1.36–2.45). We found no compelling evidence for the remaining interventions. Results were similar when using viral suppression as an outcome, although the network of evidence was sparser. Treatment supporters with enhanced SOC (OR:1.46; 95% CrI: 1.09–1.97) and weekly SMS messages (OR:1.55; 95% CrI: 1.00–2.39) were significantly superior to basic SOC. Interpretation Several recommendations for improving adherence are unsupported by the available evidence. These findings should influence guidance documents on improving ART adherence in poor settings.

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“…Together, these described 14 RCTs in our analyses (Table 1). 38, 39, 41–53 Individual level data were available for 9 of the RCTs.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Interventions to promote adherence to antiretroviral therapy in Africa: a network meta-analysis

Mills¹,

Lester²,

Thorlund³

et al. 2014

The Lancet HIV

107

View full text Add to dashboard Cite

show abstract

“…188 Other interventions addressing stigma and discrimination were implemented at single or multiple levels of the social–ecological model and targeting one or more dimensions of stigma, 189–194 although relatively few were rigorously evaluated for their effects on HIV treatment outcomes. 189–191,195,196 …”

Section: Adherencementioning

confidence: 99%

A Framework for Health Communication Across the HIV Treatment Continuum

Babalola

Lith

Mallalieu

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…With higher ART adherence CD4 counts increased and depression symptom scores decreased. Again, no significant group time interaction effect was observed for the total group for either measure 34 Two arm RCT conducted by Safren and his colleagues on 300 patients comparing CBT to enhance treatment as actually only. At the acute outcome assessment (3 month) those who receive CBT evidenced significantly greater improvement in medication adherence and depression relative to the comparison group.…”

Section: Cognitive-behavioral Strategiesmentioning

confidence: 99%

“…Group CB interventions provide a forum for modeling skills such as problem-solving, coping, and assertiveness, while promoting attitude and behavior change through increased self-efficacy. 34 CB interventions have been used to enhance patient responses to stressors and encourage active coping strategies to reduce the deleterious affective and behavioral sequelae of HIV infection. Patients obtain knowledge, adopt group norms of behavior and share concerns with peers, develop illness-management skills, improve coping and quality of life, and reduce anxiety and depression while increasing medication adherences.…”

Section: Cognitive-behavioral Strategiesmentioning

confidence: 99%