OBJECTIVES: This study aimed to determine whether use of digital refill reminders (DRR) on patients receiving antiretroviral prescription medications to treat HIV exhibited differences in medication adherence compared to matched patients not receiving DRR.

BACKGROUND: Digital communication services, including digital refill reminders, provides an efficient channel for pharmacy providers to connect with patients about their medications. Due to stigma and the need for privacy, digital communication services may be the preferred and most effective option for some HIV patients to interact with their pharmacy team. Previous studies found digital services were associated with higher adherence to certain chronic medications, but little evidence exists on digital services and antiretroviral adherence.

METHODS: Using patient prescription fill data 2016 - 2017, we conducted a retrospective propensity matched cohort study comparing medication adherence rates for a sample of patients with HIV who received antiretroviral medications along with DRR to a matched cohort of patients with HIV without receiving DRR. Patients were matched by age, gender, initial dispensing year, length of medication therapy, and multiple therapeutic classes. Adherence to antiretroviral medications was measured using a standard metric, the proportion of days covered (PDC). One-to-one matching resulted in 5,000 matched pairs. We used mixed modelling methods to assess statistical differences.

RESULTS: Mean PDC was higher for the DRR cohort versus the comparison cohort (78% vs. 72%, p<.001). Fifty-two percent of the DRR cohort had medication adherence rates (PDC) greater than or equal to the 90% adherence threshold for HIV patients who received regular DRR, compared to the comparison cohort where 44% of patients were adherent according to this threshold (p<.001).

CONCLUSIONS: These results show that patients with HIV who use DRR for their antiretroviral medications had higher medication adherence rates, which have been associated with better clinical outcomes including effective and persistent viral load suppression.