Effects of a Phone Call Intervention to Promote Adherence to Antiretroviral Therapy and Quality of Life of HIV/AIDS Patients in Baoshan, China: A Randomized Controlled Trial
Background. Suboptimal adherence to antiretroviral therapy (ART) is still pervasive. The effect of using a mobile phone call intervention to improve patient adherence is currently not known. Objective. This study aims to investigate the effects of a phone call intervention on adherence to ART and quality of life (QOL) of treatment-naive and treatment-experienced patients. Methods. A randomized controlled trial was conducted in the three largest public hospitals. Adherence was measured by self-completed questionnaires. QOL was assessed by the WHOQOL-HIV BREF. Outcomes were assessed at day 15, at 1, 2, and 3 months after start of treatment for treatment-naive patients and at 3 months after study enrollment for treatment-experienced patients. Results. A total of 103 treatment-naive and 93 treatment-experienced HIV/AIDS patients were consecutively recruited. Results show that a phone call intervention could maintain high self-reported adherence among both treatment-naive and treatment-experienced patients. After three months, significant QOL improvements were observed in domains of physical health , level of independence , environment , and spirituality/religion/personal beliefs among treatment-naive patients. Conclusion. A mobile phone call intervention to patients could maintain high adherence rates although no statistically significant differences were found. A phone call could improve some domains of QOL among treatment-naive patients. 1. Introduction Since the beginning of the HIV/AIDS epidemic in 1981, nearly 30 million people have died from AIDS-related causes [1]. Antiretroviral therapy (ART) was initiated in 1996 and has contributed greatly to the reduction in mortality and morbidity among patients with HIV/AIDS [2]. The annual number of people dying from AIDS-related causes worldwide has been steadily decreasing from a peak of 2.2 million in 2005 to an estimated 1.8 million in 2010 [3]. In China, the mortality rate has decreased from 39.3 per 100 person-years in 2002 to 14.2 per 100 person-years in 2009 [4]. While the benefits of ART are well established, poor adherence to the regimens is pervasive [2]. Nonadherence rates range from 30% to 40% in the United States of America, Latin America, and Europe [5–8], and in China, it is approximately 20% [9]. An adherence rate under 95% accounts for ART failure and results in drug resistance [10]. Thus, it is crucial for patients with HIV/AIDS to consistently comply with the regimen to decrease the risk of disease progression and drug resistance, maintaining CD4 lymphocyte count to prolong their survival
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