Meta-analysis of Mobile Phone Reminders on HIV Patients' Retention to Care.

SoSon Jong, Yvette Cuca, Lisa M Thompson
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引用次数: 13

Abstract

Aims: This research aims to systematically review the current clinical evidence of the efficacy of mobile phone reminders on retention to care among HIV patients. This study also seeks to determine an effect size of the intervention and presents implications for future studies.

Background: Use of mobile technologies is an innovative and affordable approach to HIV prevention and care, particularly in resource limited settings. Approximately two-thirds of people who are initially diagnosed with HIV are lost to follow-up before starting HIV treatment in low and middle-income countries, posing serious global health concerns. While mobile text message reminders for HIV medication adherence have shown positive health outcomes, it is not well understood whether the reminders can also improve patients' retention to care.

Methods: The authors conducted a meta-analysis of literature in the following databases: PubMed, CINAHL, ProQuest, and Web of Science. Of the 667 peer-reviewed research articles reviewed, nine studies were included in the final analysis. Stata version 13 was used for the analysis.

Results: Nine studies (5 randomized controlled and 4 before and after studies) from 7 countries included 3,004 HIV patients. Random-effect meta-analysis (I-squared = 94.1%) found that HIV patients who received mobile phone reminders for their follow-up appointments were two times more likely to return to care than those who didn't receive reminders (pooled odd ratio (OR)=2.04, 95% CI: 0.97-4.27). Our sub-group analysis of 5 randomized controlled studies showed a significant effect of mobile phone reminders (OR=2.04, 95% CI: 1.11-3.74). Six studies in Africa showed that HIV patients (mostly women) receiving mobile phone reminders were three times more likely to return to care than those who received no reminders (OR=2.92, 95% CI: 1.13-7.53).

Conclusion: Mobile phone reminders are an effective intervention to improve retention to HIV care. Women with HIV living in resource limited settings benefit significantly from the intervention. Also, mobile phone reminders using text messages are as effective as phone calls to improve retention to HIV care.

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手机提醒对HIV患者护理保留的Meta分析。
目的:本研究旨在系统地回顾当前的临床证据,证明手机提醒对HIV患者保留护理的有效性。这项研究还试图确定干预的效果大小,并为未来的研究提供启示。背景:使用移动技术是一种创新的、负担得起的艾滋病毒预防和护理方法,特别是在资源有限的情况下。在中低收入国家,最初被诊断为艾滋病毒感染者中,约有三分之二的人在开始接受艾滋病毒治疗之前失去了随访,这引发了严重的全球健康问题。虽然针对HIV药物依从性的手机短信提醒显示出积极的健康结果,但尚不清楚这些提醒是否也能提高患者的护理保留率。方法:作者对以下数据库中的文献进行了荟萃分析:PubMed、CINAHL、ProQuest和Web of Science。在审查的667篇同行评审研究文章中,有9项研究被纳入最终分析。使用Stata版本13进行分析。结果:来自7个国家的9项研究(5项随机对照研究和4项前后研究)包括3004名HIV患者。随机效应荟萃分析(I-square=94.1%)发现,收到手机提醒进行随访的HIV患者返回护理的可能性是没有收到提醒的患者的两倍(合并奇数比(OR)=2.04,95%可信区间:0.97-4.27)。我们对5项随机对照研究的亚组分析显示,手机提醒具有显著效果(OR=2.04,95%可信区间1.11-3.74)。非洲的6项研究表明,收到手机提醒的HIV患者(主要是女性)返回护理的可能性是未收到提醒的患者的三倍(OR=2.92,95%置信区间1.13-7.53)。结论:手机提醒是一种有效的干预措施,可以提高对艾滋病毒护理的保留率。生活在资源有限环境中的艾滋病毒感染妇女从干预中受益匪浅。此外,使用短信的手机提醒和打电话一样有效,可以提高对艾滋病毒护理的保留率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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