A Preliminary Test of an mHealth Facilitated Health Coaching Intervention to Improve Medication Adherence among Persons Living with HIV

Abstract

This study examined feasibility, acceptability, and preliminary efficacy of an mHealth facilitated health coaching antiretroviral therapy (ART) adherence intervention. Persons living with HIV (n = 53) were randomized to an in-person adherence session and 12 months of app access and health coaching via the app (Fitbit Plus) versus single adherence session (SOC). At baseline and 1, 3, 6, and 12 months, we measured ART adherence, substance use, and depressive symptoms. We also conducted individual qualitative interviews. The intervention was found to be largely feasible and highly acceptable, with the health coach spending an average of 2.4 min per month with a participant and 76.5% of Fitbit Plus participants using the app regularly at 12 months. While most comparisons were not significant, the pattern of results was consistent with better adherence in the Fitbit Plus compared to SOC condition. Substance use was significantly associated with poorer ART adherence while depressive symptoms were not.ClinicalTrials.gov Identifier: NCT02676128; Registered: 2/8/2016.

Keywords: HIV; Health Coaching; Medication Adherence; mHealth Intervention.

Conflict of interest statement

Conflicts of Interest: Dr. Susan Ramsey has an Investigator Sponsored Research Agreement with Gilead Science, Inc. for the provision of medication for another trial.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Figure 4.. Treatment Group Differences in Uncorrected EPB Data over Time

EPB: Electronic Pill Box/Bottle PLS: Pre-LifeSteps SOC: Standard of Care 1MFU: 1 Month Follow-up 3MFU: 3 Month Follow-up 6MFU: 6 Month Follow-up 12MFU: 12 Month Follow-up

Figure 1.. Consort Diagram

ART: Antiretroviral Therapy SOC: Standard of Care

Figure 2.. Treatment Group Differences in Self-Report Corrected EPB Data over Time

EPB: Electronic Pill Box/Bottle PLS: Pre-LifeSteps SOC: Standard of Care 1MFU: 1 Month Follow-up 3MFU: 3 Month Follow-up 6MFU: 6 Month Follow-up 12MFU: 12 Month Follow-up *p = .04

Figure 3.. Treatment Group Differences in Self-Reported Adherence over Time

SOC: Standard of Care 1MFU: 1 Month Follow-up 3MFU: 3 Month Follow-up 6MFU: 6 Month Follow-up 12MFU: 12 Month Follow-up