TY - JOUR
T1 - Real-time adherence monitoring for HIV antiretroviral therapy
AU - Haberer, Jessica E.
AU - Kahane, Josh
AU - Kigozi, Isaac
AU - Emenyonu, Nneka
AU - Hunt, Peter
AU - Martin, Jeffrey
AU - Bangsberg, David R.
N1 - Funding Information:
Acknowledgments This study was made possible by the generous contributions of Mark and Lisa Schwartz, in addition to RO-1, NIMH 54907. Jessica Haberer was supported by NIMH K-23 087228, and David Bangsberg was supported by NIMH K-24 087227. The authors would like to thank the study participants; Lloyd Marshall and Paul Bailey at Wisepill; and research assistants Abdon Birungi, Emmanuel Byaruhanga, Joy Kabasindi, Esther Susan Kanyunyuzi, Chris Mulo-kozi, and Victoria Nafuka. The manufactures of Wisepill had no role in the analysis or preparation of the manuscript and the authors have no financial interest in Wisepill.
Funding Information:
This study was approved by the ethical review boards at MUST, the Partners Human Research Committee at Massachusetts General Hospital, and the Uganda National Council for Science and Technology.
PY - 2010/12
Y1 - 2010/12
N2 - Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and selfreport were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.
AB - Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and selfreport were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.
KW - Antiretroviral therapy
KW - Real-time adherence monitoring
KW - Wireless technology
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U2 - 10.1007/s10461-010-9799-4
DO - 10.1007/s10461-010-9799-4
M3 - Article
C2 - 20809380
AN - SCOPUS:79952277560
SN - 1090-7165
VL - 14
SP - 1340
EP - 1346
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 6
ER -