Carlos del Rio, MD

In a study conducted in India among patients initiating antiretroviral therapy, a mobile phone intervention had no effect on adherence or time to virologic failure.

Mobile phones are ubiquitous, so it is not surprising that their use for health interventions has become mainstream. Nonetheless, the use of mobile phone reminders for management of HIV treatment remains controversial, because few clinical trials have been conducted on this strategy.

Now, investigators have conducted a multicenter, controlled, open-label trial to study the effect of mobile phone reminders on virologic suppression. HIV-infected patients in India who were initiating antiretroviral therapy (ART) were randomized to receive standard care (counseling before ART initiation, routine clinical and laboratory tests at baseline, and follow-up assessments every 6 months) or a mobile phone intervention (standard care plus a weekly customized, prerecorded, motivational voice call including a question about adherence the previous day). Of the 631 participants, 43.3% were women, 81.6% had at least a high school education, and 45.3% resided in a rural area.

During the 96-week follow-up period, 15.6% of patients in the intervention arm and 15.5% in the standard-care arm experienced virologic failure (failure rates per 100 person-years, 10.52 and 10.73, respectively). Adherence rates and times to virologic failure were also similar between arms.

Citation(s):

Shet A et al. Effect of mobile telephone reminders on treatment outcome in HIV: Evidence from a randomised controlled trial in India. BMJ 2014 Oct 24; 349:g5978.