Real-Time Antiretroviral Therapy Adherence Intervention in Uganda
Development of a Real-Time Antiretroviral Therapy Adherence Intervention in Uganda
調査の概要
状態
詳細な説明
In this study, the investigators propose to develop a real-time adherence intervention based on SMS (i.e., text messages), wireless adherence monitoring (with the Wisepill device), and engagement of social support that is tailored to rural sub-Saharan Africa. The investigators will build on research by others who have shown SMS reminders improve adherence and viral suppression in Kenya, albeit with relatively small effect sizes and suboptimal virologic failure rates even in the intervention arm. Moreover, little is known about which patients benefit from SMS, why they benefit, and what can be done to further improve adherence and treatment success rates. Understanding the mechanisms of effect will make it possible to design and test evidence-based interventions with the highest likelihood for efficacy.
In a cohort of HIV-infected individuals starting ART and being monitored with Wisepill, the investigators will test 1) daily SMS reminders, 2) weekly SMS reminders, 3) SMS reminders linked to real-time detection of missed doses, and 4) SMS reminders plus SMS notifications of 48+hour gaps in adherence to members of social support networks. The investigators will conduct qualitative interviews to learn the experiences of participants and members of their social support networks with the different types of SMS. This staged approach will allow us to fully understand and compare the additive effects and acceptability of SMS-based interventions. The investigators will also determine behavioral effect mechanisms, as well as compare the impact of each type of SMS with a control population receiving only Wisepill monitoring on adherence and HIV RNA.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Mbarara District
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Mbarara、Mbarara District、ウガンダ
- Mbarara Immune Suppression Syndrome(ISS) Clinic
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Wisepill Participants:
Inclusion Criteria:
- HIV-infected
- Initiating ART within the next two weeks
- Age 18 years and older
- Owns a cell phone for personal use and has reliable cellular phone reception at home on a network supported by the technology used in this study
- Lives in the Mbarara District (i.e, within 20 km of the ISS Clinic)
- Has at least one person who could be named as a social supporter(see criteria below).
Exclusion Criteria:
- Unable to use SMS
- Unwilling to receive SMS reminders
- Severe mental condition limiting the ability to provide consent
- Cellular phone reception is not reliable
Social supporters (i.e., recipients of the SMS notifications for Wisepill participants in the intervention arms):
Inclusion criteria:
- Knows Wisepill participant has HIV
- Age 18 years or older
- Reports having provided social support to the intervention participant at least once
- Own a cell phone for personal use and have reliable cellular phone reception at home on a network supported by the technology used in this study
- Lives in the Mbarara District
Exclusion criteria:
- Unable to use SMS
- Unwilling to receive SMS notifications regarding interruptions in the intervention participant's adherence
- Severe mental condition limiting the ability to provide consent
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Fixed SMS, real-time monitoring
SMS will be sent daily for one month, then weekly for two months.
Participants will have real-time adherence monitoring and social supporters will be notified of gaps in adherence of 48+ hours in the last six months of the study.
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SMS reminders will be sent daily for one month, then weekly for two months, then as needed for missed doses to encourage adherence.
The Wisepill system will automatically capture and report each time the device is opened as a proxy for the participant's adherence.
他の名前：
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実験的：Triggered SMS, real-time monitoring
Participants will have real-time adherence monitoring and social supporters will be notified of gaps in adherence of 48+ hours in the last six months of the study.
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SMS reminders will be sent as needed for missed doses to encourage adherence.
The Wisepill system will automatically capture and report each time the device is opened as a proxy for the participant's adherence.
他の名前：
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介入なし：control
Real-time adherence monitoring only (no SMS)
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Antiretroviral Therapy (ART) Adherence Levels
時間枠：real time (for 9 months)
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ART adherence in each study arms.
Adherence is measured by the Wisepill real-time adherence monitor and calculated as the number of monitor opening signals received divided by the number of monitor opening signals expected, capped at 100%.
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real time (for 9 months)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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HIV RNA Suppression
時間枠：After month 9
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HIV RNA suppression (<100 copies/ml) in each study arm
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After month 9
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協力者と研究者
捜査官
- 主任研究者：Jessica Haberer, MD, MS、Massachusetts General Hospital
- 主任研究者：Angella Musiimenta, PhD、Mbarara University of Science and Technology
出版物と役立つリンク
一般刊行物
- Musiimenta A, Atukunda EC, Tumuhimbise W, Haberer JE. Resilience after withdrawing a technology-based medication adherence support intervention from people living with HIV in rural Uganda. AIDS Care. 2018 Aug;30(sup5):S89-S96. doi: 10.1080/09540121.2018.1510107. Epub 2019 Jan 9.
- Musiimenta A, Atukunda EC, Tumuhimbise W, Pisarski EE, Tam M, Wyatt MA, Ware NC, Haberer JE. Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth. 2018 May 17;6(5):e122. doi: 10.2196/mhealth.9031.
- Haberer JE, Musiimenta A, Atukunda EC, Musinguzi N, Wyatt MA, Ware NC, Bangsberg DR. Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda. AIDS. 2016 May 15;30(8):1295-300. doi: 10.1097/QAD.0000000000001021.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- R34MH100940-01 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
HIV/エイズの臨床試験
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Fixed SMS, real-time monitoringの臨床試験
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