Data from: Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: a randomized clinical trial

Background: Adherence to treatment remains the cornerstone of long term
viral suppression and successful treatment outcomes among patients
receiving Antiretroviral Therapy (ART). Objective(s): Evaluate the
effectiveness of mobile phone reminders and peer counseling in improving
adherence and treatment outcomes among HIV positive patients on ART in
Malaysia. Methods: A single-blind, parallel group RCT conducted in
Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were
randomized to intervention or control groups. Intervention consisted of a
reminder module delivered through SMS and telephone call reminders by
trained research assistants for 24 consecutive weeks (starting from date
of ART initiation), in addition to adherence counseling at every clinic
visit. The length of intended follow up for each patient was 6 months.
Data on adherence behavior of patients was collected using specialized,
pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence
questionnaires. Data on weight, clinical symptoms, CD4 count and viral
load tests were also collected. Data was analyzed using SPSS version 22
and R software. Repeated measures ANOVA, Friedman’s ANOVA and Multivariate
regression models were used to evaluate efficacy of the intervention.
Results: The response rate after 6 months follow up was 93%. There were no
significant differences at baseline in gender, employment status, income
distribution and residential location of respondents between the
intervention and control group. After 6 months follow up, the mean
adherence was significantly higher in the intervention group (95.7; 95%
CI: 94.39–96.97) as compared to the control group (87.5; 95% CI:
86.14–88.81). The proportion of respondents who had Good (>95%)
adherence was significantly higher in the intervention group (92.2%)
compared to the control group (54.6%). A significantly lower frequency in
missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p =
0.001), higher rise in CD4 count (p = 0.017), lower incidence of
tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was
observed among patients in the intervention group. Conclusion: Mobile
phone reminders (SMS and telephone call reminders) and peer counseling are
effective in improving adherence and treatment outcomes among HIV positive
patients on ART in Malaysia. These findings may be of potential benefit
for collaborative adherence planning between patients and health care
providers at ART commencement.