A randomized trial of 'fresh start' text messaging to improve return to care in people with HIV who missed appointments in South Africa.

IF 3.4 2区 医学 Q3 IMMUNOLOGY AIDS Pub Date : 2024-08-01 Epub Date: 2024-06-10 DOI:10.1097/QAD.0000000000003939
Christine Njuguna, Lawrence Long, Preethi Mistri, Candice Chetty-Makkan, Brendan Maughan-Brown, Alison Buttenheim, Laura Schmucker, Sophie Pascoe, Harsha Thirumurthy, Cara O'Connor, Chipo Mutyambizi, Barry Mutasa, Kate Rees
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引用次数: 0

Abstract

Objective: Treatment interruptions are a barrier to successful antiretroviral therapy (ART). 'Fresh start messages', which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the potential to encourage people with HIV (PWH) to return to care. We evaluated a 'fresh start' intervention (text messages) to increase return to care in PWH who had missed their last appointment.

Design: A three arm 1 : 1:1 individual randomised controlled trial.

Methods: We randomized adults in Capricorn District who had missed ART appointments by >28 days to: no text message; unframed messages (fresh start not mentioned); or framed messages (fresh start mentioned). Randomization was stratified by treatment interruption duration and across two holidays (Youth Day, Mandela Day). The primary outcome was an ART-related clinic visit at ≤45 days of the first message.

Results: 9143 participants were randomised. For Youth Day, 1474 and 1468 were sent unframed and framed messages respectively, with 13.4% sent these messages having an ART visit vs. 11.9% not sent a message [adjusted odds ratio (aOR) 1.2; 95% confidence interval (CI): 1.0-1.4, P -value = 0.075]. For Mandela Day, 1336 and 1334 were sent unframed and framed messages respectively, with 6.7% sent these messages having an ART-related clinic visit vs. 5.4% not sent a message (aOR 1.2; 95% CI: 1.0-1.6; P -value = 0.100).

Conclusions: Low-cost text messages sent around a 'fresh start' date may increase the likelihood that patients who miss appointments return to care. This study suggests the potential of text messaging for motivating return to care.

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在南非开展了一项随机试验,通过发送 "新的开始 "短信来改善错过预约时间的艾滋病病毒感染者重返医疗机构的情况。
目的:中断治疗是抗逆转录病毒疗法(ART)成功的一个障碍。"新的开始短信 "利用日历上的重要日子(如新年、公共假日)来促使人们采取行动,有可能鼓励艾滋病病毒感染者重返治疗。我们对 "新起点 "干预措施(短信)进行了评估,以提高错过最后一次预约的艾滋病毒感染者重返医疗机构的积极性:设计:三臂 1:1:1 个人随机对照试验:我们将摩羯区错过抗逆转录病毒疗法预约超过 28 天的成人随机分配为:a) 无短信;b) 无框架短信(未提及 "从新开始");或 c) 有框架短信(提及 "从新开始")。根据治疗中断时间和两个节日(青年节和曼德拉日)进行分层随机化。主要结果是在收到第一条信息后≤45天内到抗逆转录病毒疗法相关诊所就诊:结果:9143 名参与者被随机分配。青年节期间,分别有 1474 人和 1468 人收到了无框架和有框架的信息,其中 13.4% 的人收到这些信息后进行了抗逆转录病毒疗法就诊,而 11.9% 的人没有收到信息(aOR 1.2;95% CI:1.0-1.4,p 值 = 0.075)。在曼德拉日,分别有 1336 人和 1334 人发送了无框架和有框架的短信,其中 6.7% 的人在发送这些短信后进行了抗逆转录病毒疗法相关的就诊,而 5.4% 的人没有发送短信(aOR 1.2;95% CI:1.0-1.6;p 值 = 0.100):结论:在 "重新开始 "日期前后发送低成本短信可能会增加错过预约的患者重返治疗的可能性。这项研究表明,短信具有激励患者重返医疗机构的潜力。
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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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