Advertisement

AIDS and Behavior

, Volume 19, Issue 3, pp 459–471 | Cite as

Individualized Texting for Adherence Building (iTAB): Improving Antiretroviral Dose Timing Among HIV-Infected Persons with Co-occurring Bipolar Disorder

  • David J. Moore
  • Amelia Poquette
  • Kaitlin B. Casaletto
  • Ben Gouaux
  • Jessica L. Montoya
  • Carolina Posada
  • Alexandra S. Rooney
  • Jayraan Badiee
  • Reena Deutsch
  • Scott L. Letendre
  • Colin A. Depp
  • Igor Grant
  • J. Hampton Atkinson
  • The HIV Neurobehavioral Research Program (HNRP) Group
Original Paper

Abstract

HIV+ persons with co-occurring bipolar disorder (HIV+/BD+) have elevated rates of medication nonadherence. We conducted a 30-day randomized controlled trial of a two-way, text messaging system, iTAB (n = 25), compared to an active comparison (CTRL) (n = 25) to improve antiretroviral (ARV) and psychotropic (PSY) adherence and dose timing. Both groups received medication adherence psychoeducation and daily texts assessing mood. The iTAB group additionally received personalized medication reminder texts. Participants responded to over 90 % of the mood and adherence text messages. Mean adherence, as assessed via electronic monitoring caps, was high and comparable between groups for both ARV (iTAB 86.2 % vs. CTRL 84.8 %; p = 0.95, Cliff’s d = 0.01) and PSY (iTAB 78.9 % vs. CTRL 77.3 %; p = 0.43, Cliff’s d = −0.13) medications. However, iTAB participants took ARVs significantly closer to their intended dosing time than CTRL participants (iTAB: 27.8 vs. CTRL: 77.0 min from target time; p = 0.02, Cliff’s d = 0.37). There was no group difference on PSY dose timing. Text messaging interventions may represent a low-burden approach to improving timeliness of medication-taking behaviors among difficult-to-treat populations. The benefits of improved dose timing for long-term medication adherence require additional investigation.

Keywords

Medication adherence HIV/AIDS Bipolar disorder mHealth Behavior modification Randomized controlled trial Intervention research 

Resumen

Las personas infectadas con VIH y que a la vez tienen trastorno bipolar (VIH+/BD+), tienen tasas elevadas de no adherencia a medicamentos. En el presente estudio, hemos llevado a cabo un ensayo controlado aleatorio comparando un sistema de mensajes de texto, ITAB (n = 25), con un grupo control (CTRL) (n = 25). El objectivo del estudio fue mejorar la adherencia a medicamentos antirretrovirales (ARV) y psicotrópicos (PSY) y también mejorar la sincronización de las dosis. Ambos grupos recibieron psicoeducación sobre la importancia de la adherencia a los medicamentos y textos diarios evalúando el estado de ánimo. El grupo ITAB recibió adicionalmente mensajes de textos personalizados que les recordaban tomar los medicamentos. Todos los participantes respondieron a más del 90 % de los mensajes de texto sobre el estado de ánimo y la adherencia. El promedio de adherencia, evaluado a través de las tapaderas de monitoreo electrónico fue alto y comparable entre los grupos para los dos medicamentos, ARV (ITAB 86,2 % frente a 84,8 % CTRL; p = 0,95, Cliff’s d = 0,01) y PSY (ITAB 78,9 % frente a 77,3 % CTRL; p = 0,43, Cliff’s d = −0,13). Sin embargo, los participantes en el grupo ITAB tomaron medicamentos ARV significativamente más cerca del tiempo en que debían tomarlos que los participantes CTRL (ITAB : 27,8 vs. CTRL : 77,0 minutos desde el momento en que debían tomarlos; p = 0,02, Cliff’s d = 0,37). No hubo diferencia entre los grupos en la sincronización de la dosis para los medicamentos PSY. En conclusión, intervenciones utilizando mensajes de texto pueden representar una forma mas fácil de mejorar la puntualidad en la que individuos difíciles de tratar deben tomarse los medicamentos. Sin embargo, los beneficios de mejorar la sincronización en la dosis de medicamentos y la adherencia a estos a largo plazo requieren investigación adicional.

Notes

Acknowledgments

The present work was supported by California HIV/AIDS Research Program IDEA Award ID09-SD-047 (D.J. Moore, PI) as well as the HIV Neurobehavioral Research Center (HNRC) NIMH/CSPAR Award Number P30MH062512 (R.K. Heaton, PI).

References

  1. 1.
    Thompson MA, Aberg JA, Hoy JF, Telenti A, Benson C, Cahn P, et al. Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society-USA panel. JAMA. 2012;308(4):387–402.CrossRefPubMedGoogle Scholar
  2. 2.
    Bangsberg DR. Preventing HIV antiretroviral resistance through better monitoring of treatment adherence. J Infect Dis. 2008;197(Suppl 3):S272–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Bangsberg DR, Deeks SG. Is average adherence to HIV antiretroviral therapy enough? J Gen Intern Med. 2002;17(10):812–3.CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Mannheimer S, Friedland G, Matts J, Child C, Chesney M. The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clin Infect Dis. 2002;34(8):1115–21.CrossRefPubMedGoogle Scholar
  5. 5.
    Mathes T, Pieper D, Antoine SL, Eikermann M. Adherence-enhancing interventions for highly active antiretroviral therapy in HIV-infected patients—a systematic review. HIV Med. 2013;14(10):583–95.CrossRefPubMedGoogle Scholar
  6. 6.
    Liu H, Miller LG, Hays RD, Golin CE, Wu T, Wenger NS, et al. Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. J Acquir Immune Defic Syndr. 2006;41(3):315–22.CrossRefPubMedGoogle Scholar
  7. 7.
    Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2007;4(2):65–72.CrossRefPubMedGoogle Scholar
  8. 8.
    Parienti JJ, Das-Douglas M, Massari V, Guzman D, Deeks SG, Verdon R, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS ONE. 2008;3(7):e2783.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Ghidei L, Simone MJ, Salow MJ, Zimmerman KM, Paquin AM, Skarf LM, et al. Aging, antiretrovirals, and adherence: a meta analysis of adherence among older HIV-infected individuals. Drugs Aging. 2013;30(10):809–19.CrossRefPubMedGoogle Scholar
  10. 10.
    Moore DJ, Blackstone K, Woods SP, Ellis RJ, Atkinson JH, Heaton RK, et al. Methamphetamine use and neuropsychiatric factors are associated with antiretroviral non-adherence. AIDS Care. 2012;24(12):1504–13.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    Moore DJ, Posada C, Parikh M, Arce M, Vaida F, Riggs PK, et al. HIV-infected individuals with co-occurring bipolar disorder evidence poor antiretroviral and psychiatric medication adherence. AIDS Behav. 2012;16(8):2257–66.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Weiser SD, Wolfe WR, Bangsberg DR. The HIV epidemic among individuals with mental illness in the United States. Curr HIV/AIDS Rep. 2004;1(4):186–92.CrossRefPubMedGoogle Scholar
  13. 13.
    Woodward EN, Pantalone DW. The role of social support and negative affect in medication adherence for HIV-infected men who have sex with men. AIDS Care. 2012;23(5):388–96.CrossRefGoogle Scholar
  14. 14.
    Beyer JL, Taylor L, Gersing KR, Krishnan KR. Prevalence of HIV infection in a general psychiatric outpatient population. Psychosomatics. 2007;48(1):31–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Walkup J, Crystal S, Sambamoorthi U. Schizophrenia and major affective disorder among Medicaid recipients with HIV/AIDS in New Jersey. Am J Public Health. 1999;89(7):1101–3.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Springer SA, Dushaj A, Azar MM. The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review. AIDS Behav. 2012;16(8):2119–43.CrossRefPubMedCentralPubMedGoogle Scholar
  17. 17.
    Mellins CA, Havens JF, McDonnell C, Lichtenstein C, Uldall K, Chesney M, et al. Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders. AIDS Care. 2009;21(2):168–77.CrossRefPubMedGoogle Scholar
  18. 18.
    Scott J, Pope M. Nonadherence with mood stabilizers: prevalence and predictors. J Clin Psychiatry. 2002;63(5):384–90.CrossRefPubMedGoogle Scholar
  19. 19.
    Colom F, Vieta E, Tacchi MJ, Sanchez-Moreno J, Scott J. Identifying and improving non-adherence in bipolar disorders. Bipolar Disord. 2005;7(Suppl 5):24–31.CrossRefPubMedGoogle Scholar
  20. 20.
    Li J, McCombs JS, Stimmel GL. Cost of treating bipolar disorder in the California Medicaid (Medi-Cal) program. J Affect Disord. 2002;71(1–3):131–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Binford MC, Kahana SY, Altice FL. A systematic review of antiretroviral adherence interventions for HIV-infected people who use drugs. Curr HIV/AIDS Rep. 2012;9(4):287–312.CrossRefPubMedGoogle Scholar
  22. 22.
    Centers for Disease Control and Prevention (CDC). Compendium of evidence-based HIV behavioral interventions. 2013. http://www.cdc.gov/hiv/prevention/research/compendium/ma/complete.html.
  23. 23.
    Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed J E Health. 2009;15(3):231–40.CrossRefPubMedGoogle Scholar
  24. 24.
    Coomes CM, Lewis MA, Uhrig JD, Furberg RD, Harris JL, Bann CM. Beyond reminders: a conceptual framework for using short message service to promote prevention and improve healthcare quality and clinical outcomes for people living with HIV. AIDS Care. 2012;24(3):348–57.CrossRefPubMedGoogle Scholar
  25. 25.
    Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PLoS ONE. 2014;9(2):e88166.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    Horvath T, Azman H, Kennedy GE, Rutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. Cochrane Database Syst Rev. 2014;14:CD009756.Google Scholar
  27. 27.
    Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010;376(9755):1838–45.CrossRefPubMedGoogle Scholar
  28. 28.
    Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, de Walque D, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011;25(6):825–34.CrossRefPubMedCentralPubMedGoogle Scholar
  29. 29.
    Dowshen N, Kuhns LM, Johnson A, Holoyda BJ, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. J Med Internet Res. 2012;14(2):e51.CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Bauer M, Grof P, Gyulai L, Rasgon N, Glenn T, Whybrow PC. Using technology to improve longitudinal studies: self-reporting with ChronoRecord in bipolar disorder. Bipolar Disord. 2004;6(1):67–74.CrossRefPubMedGoogle Scholar
  31. 31.
    Bopp JM, Miklowitz DJ, Goodwin GM, Stevens W, Rendell JM, Geddes JR. The longitudinal course of bipolar disorder as revealed through weekly text messaging: a feasibility study. Bipolar Disord. 2010;12(3):327–34.CrossRefPubMedCentralPubMedGoogle Scholar
  32. 32.
    Wenze SJ, Armey MF, Miller IW. Feasibility and acceptability of a mobile intervention to improve treatment adherence in bipolar disorder: a pilot study. Behavior Modif. 2014.Google Scholar
  33. 33.
    Depp CA, Mausbach B, Granholm E, Cardenas V, Ben-Zeev D, Patterson TL, et al. Mobile interventions for severe mental illness: design and preliminary data from three approaches. J Nerv Mental Dis. 2010;198(10):715–21.CrossRefGoogle Scholar
  34. 34.
    Schulz KF, Altman DG, Moher D, Group C. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8:18.CrossRefGoogle Scholar
  35. 35.
    Balfour L, Kowal J, Silverman A, Tasca GA, Angel JB, Macpherson PA, et al. A randomized controlled psycho-education intervention trial: improving psychological readiness for successful HIV medication adherence and reducing depression before initiating HAART. AIDS Care. 2006;18(7):830–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Colom F, Vieta E, Reinares M, Martinez-Aran A, Torrent C, Goikolea JM, et al. Psychoeducation efficacy in bipolar disorders: beyond compliance enhancement. J Clin Psychiatry. 2003;64(9):1101–5.CrossRefPubMedGoogle Scholar
  37. 37.
    Glanz K, Rimer BK. Theory at a glance: a guide for health promotion practice. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute; 1997.Google Scholar
  38. 38.
    Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429–35.CrossRefPubMedGoogle Scholar
  39. 39.
    Beck AT, Steer RA, Brown GK. BDI: Beck Depression Inventory: Manual. San Antonio: Psychological Corporation; 1996.Google Scholar
  40. 40.
    Badiee J, Riggs PK, Rooney AS, Vaida F, Grant I, Atkinson JH, et al. Approaches to identifying appropriate medication adherence assessments for HIV infected individuals with comorbid bipolar disorder. AIDS Patient Care STDs. 2012;26(7):388–94.PubMedCentralPubMedGoogle Scholar
  41. 41.
    Heaton RK, Franklin DR, Ellis RJ, McCutchan JA, Letendre SL, Leblanc S, et al. HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. J Neurovirol. 2011;17(1):3–16.CrossRefPubMedCentralPubMedGoogle Scholar
  42. 42.
    Cliff N. Dominance statistics: ordinal analyses to answer ordinal questions. Psychol Bull. 1993;114(3):494.CrossRefGoogle Scholar
  43. 43.
    Hoogenhout EM, de Groot RH, van der Elst W, Jolles J. Effects of a comprehensive educational group intervention in older women with cognitive complaints: a randomized controlled trial. Aging Mental Health. 2012;16(2):135–44.CrossRefPubMedGoogle Scholar
  44. 44.
    Romano J, Kromrey JD, Coraggio J, Skowronek J, Devine L. Exploring methods for evaluating group differences on the NSSE and other surveys: Are the t-test and Cohen’s d indices the most appropriate choices? Paper presented at the annual meeting of the Southern Association for Institutional Research; October 14–17, 2006; Arlington, Virginia.Google Scholar
  45. 45.
    Gill CJ, Sabin LL, Hamer DH, Keyi X, Jianbo Z, Li T, et al. Importance of dose timing to achieving undetectable viral loads. AIDS Behav. 2010;14(4):785–93.CrossRefPubMedGoogle Scholar
  46. 46.
    Pompili M, Venturini P, Palermo M, Stefani H, Seretti ME, Lamis DA, et al. Mood disorders medications: predictors of nonadherence—review of the current literature. Expert Rev Neurother. 2013;13(7):809–25.CrossRefPubMedGoogle Scholar
  47. 47.
    Garfein R, Collins K, Muñoz F, Moser K, Cerecer-Callu P, Sullivan M, et al., editors. Use of mobile phones for video directly observed therapy among tuberculosis patients in high and low income countries. Wireless Health; 2013 Nov 1–3; Baltimore.Google Scholar
  48. 48.
    Bobrow K, Brennan T, Springer D, Levitt NS, Rayner B, Namane M, et al. Efficacy of a text messaging (SMS) based intervention for adults with hypertension: protocol for the StAR (SMS Text-message Adherence suppoRt trial) randomised controlled trial. BMC Public Health. 2014;14:28.CrossRefPubMedCentralPubMedGoogle Scholar
  49. 49.
    Muench F, van Stolk-Cooke K, Morgenstern J, Kuerbis AN, Markle K. Understanding messaging preferences to inform development of mobile goal-directed behavioral interventions. J Med Internet Res. 2014;16(2):e14.CrossRefPubMedCentralPubMedGoogle Scholar
  50. 50.
    Wendel CS, Mohler MJ, Kroesen K, Ampel NM, Gifford AL, Coons SJ. Barriers to use of electronic adherence monitoring in an HIV clinic. Ann Pharmacother. 2001;35(9):1010–5.CrossRefPubMedGoogle Scholar
  51. 51.
    Bova CA, Fennie KP, Knafl GJ, Dieckhaus KD, Watrous E, Williams AB. Use of electronic monitoring devices to measure antiretroviral adherence: practical considerations. AIDS Behav. 2005;9(1):103–10.CrossRefPubMedGoogle Scholar
  52. 52.
    Levine AJ, Hinkin CH, Castellon SA, Mason KI, Lam MN, Perkins A, et al. Variations in patterns of highly active antiretroviral therapy (HAART) adherence. AIDS Behav. 2005;9(3):355–62.CrossRefPubMedGoogle Scholar
  53. 53.
    Walsh JC, Mandalia S, Gazzard BG. Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. AIDS. 2002;16(2):269–77.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • David J. Moore
    • 1
    • 5
  • Amelia Poquette
    • 1
    • 5
  • Kaitlin B. Casaletto
    • 2
    • 5
  • Ben Gouaux
    • 1
    • 5
  • Jessica L. Montoya
    • 2
    • 5
  • Carolina Posada
    • 2
    • 5
  • Alexandra S. Rooney
    • 1
    • 5
  • Jayraan Badiee
    • 1
    • 5
  • Reena Deutsch
    • 1
    • 5
  • Scott L. Letendre
    • 3
    • 5
  • Colin A. Depp
    • 1
  • Igor Grant
    • 1
    • 5
  • J. Hampton Atkinson
    • 1
    • 4
    • 5
  • The HIV Neurobehavioral Research Program (HNRP) Group
  1. 1.Department of Psychiatry, School of MedicineUniversity of California, San DiegoLa JollaUSA
  2. 2.SDSU/UCSD Joint Doctoral Program in Clinical PsychologySan DiegoUSA
  3. 3.Department of Medicine, School of MedicineUniversity of California, San DiegoLa JollaUSA
  4. 4.Psychiatry Service, VA San Diego Healthcare SystemSan DiegoUSA
  5. 5.HIV Neurobehavioral Research ProgramSan DiegoUSA

Personalised recommendations