[ARCHIVED] Adherence & Retention

Real-time adherence monitoring

Started by Jessica Haberer, MD, MS on 07 Sep 2010

Dear Colleagues,

I'm pleased to share the following abstract, "Real-time Adherence
Monitoring for HIV Antiretroviral Therapy". The publishing journal, AIDS and Behavior, kindly made the paper available free of charge:

Free HTML http://www.springerlink.com/content/4012134j345l2825/fulltext.html
Free PDF http://www.springerlink.com/content/4012134j345l2825/fulltext.pdf

This pilot study is proof-of-concept that adherence lapses can be detected in real-time in a resource limited setting, potentially before the development of viral rebound. We believe that real-time monitoring has the potential to change HIV treatment monitoring from a reactive response to proactive prevention of viral failure. We are currently expanding this work with larger numbers of adults and children and will present further data at the mHealth Summit (www.mhealthsummit.org) in Washington DC this November.

Sincerely,
Jessica


AIDS Behav. 2010 Aug 31. [Epub ahead of print]
Real-Time Adherence Monitoring for HIV Antiretroviral Therapy.
Haberer JE, Kahane J, Kigozi I, Emenyonu N, Hunt P, Martin J, Bangsberg DR.

Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and self-report were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.