Journal Article

Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review

Ezuma, Amarachi D., Irem, Franklin Onyedinma, Fortwengel, Gerhard, Myezwa, Hellen, Ezenwankwo, Fortune Elochukwu, Ajidahun, Adedayo Tunde, Ndukwu, Sandra C., Nnamani, Amaka, Uwakwe, Victor C., Onodugo, Obinna, Ibeneme, Sam Chidi

2021

Overview

Background Mobile text reminder (SMS) system is considered a viable strategy for targeting/facilitating healthy behavioural change including adherence to prescribed physical exercises (PE) and medication (antiretroviral therapy-ART) which should improve the quality of life (Qol) in people living with HIV/AIDS(PLWHA). Thus, the literature was appraised for evidence of SMS effectiveness in improving ART and PE adherence behaviours and QoL in PLWHA. Methods Eight databases–AMED, CINAHL, Cochrane Library, EMBASE, EMCARE, Ovid MEDLINE, PsycINFO, and PubMed-were searched up to December 2020, using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol.This review included only randomised control trials (RCTs) investigating the effectiveness of SMS in improving QoL or PE or ART adherence behaviour or a combination of these variables in PLWHA >18 years. Two independent reviewers determined the eligibility of the studies. Data were extracted and the quality of the study was assessed with the Physiotherapy Evidence Database (PEDro) tool. The primary outcomes were ART and PE adherence behaviours while the secondary outcome was QoL. Result A pooled estimate of effect was not calculated due to the heterogeneity of methods and outcome measures. Therefore, a narrative synthesis of ten studies that met the inclusion criteria (n = 1621 participants at study completion) comprising males/females, aged ≥ 18 years, was done. There was a significant improvement in ART adherence behaviour except in three underpowered studies. Only the SMS interventions that were developed using the Starks 3-steps Adherence model was associated with positive outcome. The only study that evaluated QoL was underpowered and reported no significant change while there were no RCTs on PE. Conclusion Effects of SMS intervention trends towards a significant improvement in ART adherence behaviour in PLWHA. It is plausible that SMS reminders developed using the broader framework of the interpersonal health behaviour theory(ies) may have positive outcome. Nevertheless, the observed heterogeneity in the methods/outcome measures warrants a cautious interpretation of the findings. There is a lack/paucity of RCTs and therefore no evidence in support of the effectiveness of SMS intervention in improving PE adherence and QoL. Registration number NPLASY202060016.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Aged / AIDS / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / Beliefs, opinions and attitudes / Care and treatment / Cell Phone / Clinical trials / Demographic aspects / Exercise / Female / Health aspects / Heterogeneity / HIV / HIV and co-infections / HIV Infections - drug therapy / HIV patients / Human immunodeficiency virus / Humans / Infectious Diseases / Internal Medicine / Male / Management / Medical Microbiology / Medication Adherence / Medicine / Medicine & Public Health / Meta-analysis / Parasitology / Patient compliance / Physical exercise / Physical exercise adherence / Physical fitness / Physical therapy / Quality of Life / Research Article / Short message service / Technology application / Text Messaging / Text-message / Tropical Medicine