Importance of Dose Timing to Achieving Undetectable Viral Loads

Gill, Christopher J.; Sabin, Lora; Hamer, Davidson H.; Xu, Ke; Zhang, Jianbo; Li, Tao; Wu, Wan‐Ju; Wilson, Ira B.; DeSilva, Mary Bachman

doi:10.1007/s10461-009-9555-9

Cited by 38 publications

(43 citation statements)

References 23 publications

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“…Adherence was defined as proportion of doses taken on time, in accordance with our past research (and that of others) showing that on-time adherence predicted undetectable viral load (UDVL) most significantly. 48,49 Accordingly, adherence was defined as: ([number of doses taken ±1 hour of dose time] / [total number of prescribed doses]). Doses taken outside the ±1 hour window were considered non-adherent.…”

Section: Methodsmentioning

confidence: 99%

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Sabin

DeSilva

Gill

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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130

167

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Background Real-time adherence monitoring is now possible through medication storage devices equipped with cellular technology. We assessed the effect of triggered cell phone reminders and counseling utilizing objective adherence data on antiretroviral (ART) adherence among Chinese HIV-infected patients. Methods We provided ART patients in Nanning, China, with a medication device (“Wisepill”) to monitor their ART adherence electronically. After 3 months, we randomized subjects within optimal (≥95%) and suboptimal (<95%) adherence strata to intervention vs. control arms. In months 4–9, intervention subjects received individualized reminders triggered by late dose-taking (no device-opening by 30 minutes past dose time), and counseling using device-generated data. Controls received no reminders or data-informed counseling. We compared post-intervention proportions achieving optimal adherence, mean adherence, and clinical outcomes. Results Of 120 subjects enrolled, 116 (96.7%) completed the trial. Pre-intervention, optimal adherence was similar in intervention vs. control arms (63.5% vs. 58.9%, respectively; p=0.60). In the last intervention month, 87.3% vs. 51.8% achieved optimal adherence (risk ratio (RR) 1.7, 95% Confidence Interval (CI) 1.3–2.2); mean adherence was 96.2% vs. 89.1% (p=0.003). Among pre-intervention suboptimal adherers, 78.3% vs. 33.3% (RR 2.4, CI 1.2–4.5) achieved optimal adherence; mean adherence was 93.3% vs. 84.7% (p=0.039). Proportions were 92.5% and 62.9% among optimal adherers, respectively (RR 1.5, CI 1.1–1.9); mean adherence was 97.8% vs. 91.7% (p=0.028). Post-intervention differences in clinical outcomes were not significant. Conclusion Real-time reminders significantly improved ART adherence in this population. This approach appears promising for managing HIV and other chronic diseases and warrants further investigation and adaptation in other settings.

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Section: Methodsmentioning

confidence: 99%

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Sabin

DeSilva

Gill

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

130

167

View full text Add to dashboard Cite

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“…The baseline value of adherence was calculated at session 1, two weeks after baseline (given that participants were not given Wisepill until the end of their baseline visit, session 1 data represents the first two week period of participants using Wisepill). On-time adherence scores have been found to significantly predict viral load, over and above total adherence counts, highlighting their importance in managing HIV (Gill, Sabin, Hamer et al, 2010; Liu, Miller, Hays et al, 2006). …”

Section: Methodsmentioning

confidence: 99%

Cognitive behavioral therapy for body image and self-care (CBT-BISC) in sexual minority men living with HIV: A randomized controlled trial.

Blashill¹,

Safren²,

Wilhelm³

et al. 2017

Health Psychology

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Objective Body image disturbance is a distressing and interfering problem among many sexual minority men living with HIV, and is associated with elevated depressive symptoms and poor HIV self-care (e.g., antiretroviral therapy [ART] non-adherence). The current study tested the preliminary efficacy of a newly created intervention: cognitive behavioral therapy for body image and self-care (CBT-BISC) for this population. Methods The current study entailed a two-arm randomized controlled trial (N = 44) comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition. Analyses were conducted at 3 and 6 months after baseline. The primary outcome was body image disturbance (BDD-YBOCS), and secondary outcomes were ART adherence (electronically monitored via Wisepill), depressive symptoms (MADRS), and global functioning (GAF). Results At 3 months, the CBT-BISC condition showed substantial improvement in BDD-YBOCS (b = −13.6, SE = 2.7, 95% CI: −19.0, −8.3, p < .001; dppc2 = 2.39), MADRS (b = −4.9, SE = 2.8, 95% CI: −10.6, .70, p = .086; dppc2 = .87), ART adherence (b = 8.8, SE = 3.3, 95% CI: 2.0, 15.6, p = .01; dppc2 = .94), and GAF (b = 12.3, SE = 3.2, 95% CI: 6.1, 18.6, p < .001; dppc2 = 2.91) compared to the ETAU condition. Results were generally maintained, or improved, at 6 months; although, adherence findings were mixed depending on the calculation method. Conclusions CBT-BISC shows preliminary efficacy in the integrated treatment of body image disturbance and HIV self-care behaviors among sexual minority men living with HIV.

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“…The dose timing has been previously reported as an important factor to achieve virological success with antiretroviral therapy (33,34). The added value of incorporating dose timing errors has received less scrutiny.…”

Section: Discussionmentioning

confidence: 99%

Adherence Profiles and Therapeutic Responses of Treatment-Naive HIV-Infected Patients Starting Boosted Atazanavir-Based Therapy in the ANRS 134-COPHAR 3 Trial

Parienti

Barrail-Tran

Duval

et al. 2013

Antimicrob Agents Chemother

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hThe adherence profile of HIV-infected patients predicts the therapeutic outcome, in particular during the early phase of antiretroviral therapy (ART). We conducted a prospective observational multicenter trial monitoring adherence and virological and immunological parameters over the initial 6 months of treatment. Thirty-five subjects were starting a treatment regimen including atazanavir, ritonavir, and emtricitabine-tenofovir. Adherence was assessed using self-completed questionnaires, announced pill counts, and the medication event monitoring system (

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Importance of Dose Timing to Achieving Undetectable Viral Loads

Cited by 38 publications

References 23 publications

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Cognitive behavioral therapy for body image and self-care (CBT-BISC) in sexual minority men living with HIV: A randomized controlled trial.

Adherence Profiles and Therapeutic Responses of Treatment-Naive HIV-Infected Patients Starting Boosted Atazanavir-Based Therapy in the ANRS 134-COPHAR 3 Trial

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