Feasibility and Acceptability of a Real-Time Adherence Device among HIV-Positive IDU Patients in China

Mary Bachman Desilva, Allen L Gifford, Xu Keyi, Zhong Li, Cheng Feng, Mohamad Brooks, Mark Harrold, Hu Yueying, Christopher J Gill, Xie Wubin, Taryn Vian, Jessica Haberer, David Bangsberg, Lora Sabin, Mary Bachman Desilva, Allen L Gifford, Xu Keyi, Zhong Li, Cheng Feng, Mohamad Brooks, Mark Harrold, Hu Yueying, Christopher J Gill, Xie Wubin, Taryn Vian, Jessica Haberer, David Bangsberg, Lora Sabin

Abstract

We collected data on feasibility and acceptability of a real-time web-linked adherence monitoring container among HIV-positive injection drug users (IDU) in China. "Wisepill" uses wireless technology to track on-time medication dosing. Ten patients on antiretroviral therapy (ART) at the Guangxi CDC HIV clinic in Nanning, China, used Wisepill for one ART medication for one month. We monitored device use and adherence and explored acceptability of the device among patients. Mean adherence was 89.2% (SD 10.6%). Half of the subjects reported a positive overall experience with Wisepill. Seven said that it was inconvenient, supported by comments that it was large and conspicuous. Five worried about disclosure of HIV status due to the device; no disclosures were reported. Twelve signal lapses occurred (5.4% of prescribed doses), of which one was due to technical reasons, nine to behavioral reasons (both intentional and unintentional), and two to unclear reasons. Although the technical components must be monitored carefully, and acceptability to patients presents challenges which warrant further exploration, the Wisepill device has potential for adherence interventions that deliver rapid adherence-support behavioral feedback directly to patients, including IDU. The use of wireless technology appears uniquely promising for providing time-sensitive communication on patient behavior that can be harnessed to maximize the benefits of HIV treatment.

Figures

Figure 1
Figure 1
The Wisepill device.

References

    1. Ministry of Health. 2012 China AIDS Response Progress. Beijing, China: Ministry of Health and People's Republic of China; 2012.
    1. Wang H, He G, Li X, et al. Self-reported adherence to antiretroviral treatment among HIV-infected people in Central China. AIDS Patient Care and STDs. 2008;22(1):71–80.
    1. Sabin LL, DeSilva MB, Hamer DH, et al. Barriers to adherence to antiretroviral medications among patients living with HIV in southern China: a qualitative study. AIDS Care. 2008;20(10):1242–1250.
    1. Charlton KE, Bourne LT, Steyn K, Laubscher JA. Poor nutritional status in older black South Africans. Asia Pacific Journal of Clinical Nutrition. 2001;10(1):31–38.
    1. Horvath T, Azman H, Kennedy GE, Rutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. Cochrane Database of Systematic Reviews. 2012;3CD009756
    1. Tran BX, Houston S. Mobile phone-based antiretroviral adherence support in Vietnam: feasibility, patient's preference, and willingness-to-pay. AIDS and Behavior. 2012;16(7):1988–1992.
    1. Rodrigues R, Shet A, Antony J, et al. Supporting adherence to antiretroviral therapy with mobile phone reminders: results from a cohort in South India. PLoS ONE. 2012;7(8)e40723
    1. Scanlon ML, Vreeman RC. Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings. HIV AIDS. 2013;5:1–17.
    1. Parienti J, Das-Douglas M, Massari V, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS ONE. 2008;3(7)e2783
    1. Boyce JM, Cooper T, Dolan MJ. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use. Infection Control and Hospital Epidemiology. 2009;30(11):1090–1095.
    1. Walji MF, Coker O, Valenza JA, Henson H, Warren-Morris D, Zhong L. A persuasive toothbrush to enhance oral hygiene adherence. AMIA Annual Symposium Proceedings. 2008:p. 1167.
    1. Haberer JE, Kahane J, Kigozi I, et al. Real-time adherence monitoring for HIV antiretroviral therapy. AIDS and Behavior. 2010;14(6):1340–1346.
    1. Siedner MJ, Lankowski A, Musinga D, et al. Optimizing network connectivity for mobile health technologies in sub-Saharan Africa. PLoS ONE. 2012;7(9)e45643
    1. Sabin LL, DeSilva MB, Hamer DH, et al. Using electronic drug monitor feedback to improve adherence to antiretroviral therapy among HIV-positive patients in China. AIDS and Behavior. 2010;14(3):580–589.
    1. Burns MN, Begale M, Duffecy J, et al. Harnessing context sensing to develop a mobile intervention for depression. Journal of Medical Internet Research. 2011;13(3):p. e55.
    1. Gill CJ, Sabin LL, Hamer DH, et al. Importance of dose timing to achieving undetectable viral loads. AIDS and Behavior. 2010;14(4):785–793.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe