OBJECTIVES

Antiretroviral therapy (ART) is an effective approach to prevent progression of HIV to AIDS, however adherence to HIV medication is still inconclusive. Currently, mobile health intervention (mHealth) is a novel way of delivering healthcare and improving health outcomes. Therefore, a meta-analysis is conducted to investigate effect of mHealth intervention on ART adherence in HIV infected patients.

METHODS

A systematic literature search in EMBASE, MEDLINE, and Cochrane CENTRAL was conducted to identify randomized controlled trials (RCTs) comparing mHealth intervention (voice calls and text messages) with control in HIV infected patients. We calculated odd ratio (OR) with 95% confidence interval (CI) to compare mHealth interventions with control group. Meta-analysis was performed by using RevMan 5.3 software.

RESULTS

Out of 1235 articles, 14 RCTs with 2861 patients met the inclusion criteria. Patient’s age were > 14 years and mHealth interventions reported as voice call in 5 studies and text messages in 9 studies.

Results from meta-analysis of overall mHealth interventions showed a significant improvement (OR: 1.51, 95%CI: 1.19-1.93; P=0.0008) in adherence to ART in HIV patients when compared to control group. From subgroup analysis, voice calls showed non-significant association (OR: 1.63, 95%CI: 0.91-2.92; P=0.10) and text messages showed significant association (OR: 1.44, 95%CI: 1.12-1.86; P=0.004) compared to control group. However, subgroup meta-analysis of text messages, scheduled text messages showed significant improvement (OR: 1.69, 95%CI: 1.24-2.29; P=0.0008) and triggered messages failed to show significant association (OR: 1.09, 95%CI: 0.81-1.46; P=0.58) in adherence to ART compared to the control group.

CONCLUSIONS

Overall mHealth interventions have significant improvement on ART adherence in HIV infected patients. However, from subgroup data only text messages (scheduled) showed significant improvement in ART adherence, and voice calls and triggered text messages do not have promising impact. Further long term RCTs with large sample size required to explore voice functions in combination with text messages.