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Using Technology to Improve Adherence to HIV Medications in Transitional Age Youth: Research Reviewed, Methods Tried,

E S Spratt1, C E Papa1, M Mueller2

  • 1Department of Pediatrics, Medical University of South Carolina, USA.

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|October 23, 2018
PubMed
Summary

Improving medication adherence in youth with HIV is crucial. This study found that technology like electronic pillboxes and motivational interviewing shows promise for enhancing adherence and health outcomes in non-adherent young patients.

Keywords:
AdherenceAdolescentsHIVHuman immunodeficiency virusNon-adherence

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Area of Science:

  • Pediatric Infectious Diseases
  • Adolescent Health
  • HIV/AIDS Research

Background:

  • Non-adherence to antiretroviral medication in youth with HIV/AIDS leads to resistance, disease progression, and mortality.
  • Transitional age youth (12-20 years) are a vulnerable population with specific adherence challenges.
  • Effective strategies are needed to improve medication adherence in this demographic.

Purpose of the Study:

  • To assess the feasibility of using the Maya MedMinder electronic pillbox and cell phone texting with motivational interviewing (MI) to improve medication adherence in non-adherent youth with HIV.
  • To evaluate the impact of these interventions on adherence scores and biomarker outcomes (viral load, CD4 counts).

Main Methods:

  • A feasibility study involving 15 non-adherent youth (ages 12-20) with HIV.
  • Randomization to intervention groups with electronic pillbox reminder signals on or off.
  • Utilized electronic pillbox data for adherence monitoring and Motivational Interviewing Stages of Change for readiness assessment.
  • Scheduled viral load and CD4 labs every 6 weeks.

Main Results:

  • Recruitment and adherence to the study protocol were challenging, with only 6/15 participants completing the 6-month study.
  • Participants showing progress in Stages of Change scores had higher CD4 percentages midway.
  • Challenges included missed appointments, lab work, and technical issues with the electronic pillbox, particularly in rural areas.

Conclusions:

  • The methodology combining technological tools (electronic pillboxes, texting) and motivational enhancement strategies is feasible for promoting adherence in non-adherent youth with HIV.
  • These interventions show potential to enhance biomarker outcomes associated with medication adherence in this population.
  • Further research with larger sample sizes is warranted to confirm efficacy and address identified challenges.