scholarly journals Real-Time Electronic Adherence Monitoring is Feasible, Comparable to Unannounced Pill Counts, and Acceptable

2011 ◽  
Vol 16 (2) ◽  
pp. 375-382 ◽  
Author(s):  
Jessica E. Haberer ◽  
Gregory K. Robbins ◽  
Michele Ybarra ◽  
Alexandra Monk ◽  
Kathleen Ragland ◽  
...  
Keyword(s):  
Real Time ◽  
Pill Counts ◽  
Adherence Monitoring

scholarly journals Testing a Real-Time Tenofovir Urine Adherence Assay for Monitoring and Providing Feedback to Preexposure Prophylaxis in Kenya (PUMA): Protocol for a Pilot Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Paul Drain ◽  
Kenneth Ngure ◽  
Nelly Mugo ◽  
Matthew Spinelli ◽  
Purba Chatterjee ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Real Time ◽  
Point Of Care ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Randomized Controlled ◽  
Preexposure Prophylaxis ◽  
Adherence Monitoring ◽  
First Time

BACKGROUND The worldwide expansion of preexposure prophylaxis (PrEP) with oral tenofovir-disoproxil-fumarate/emtricitabine will be critical to ending the HIV epidemic. However, maintaining daily adherence to PrEP can be difficult, and the accuracy of self-reported adherence is often limited by social desirability bias. Pharmacologic adherence monitoring (measuring drug levels in a biomatrix) has been critical to interpreting PrEP trials, but testing usually requires expensive equipment and skilled personnel. We have recently developed a point-of-care (POC) immunoassay to measure tenofovir in urine, allowing real-time adherence monitoring for the first time. OBJECTIVE The goal of this study is to examine a point-of-care adherence metric in PrEP to support and increase adherence via a randomized controlled trial. METHODS The paper describes the protocol for a pilot randomized controlled trial to test the acceptability, feasibility, and impact on long-term adherence of implementing a POC urine test to provide real-time adherence feedback among women on PrEP. Eligible women (n=100) will be HIV-negative, ≥18 years old, and recruited from a clinic in Kenya that provides PrEP. Participants will be randomized 1:1 to the intervention of providing real-time feedback via the assay versus standard of care adherence counseling. Acceptability by participants will be assessed by a quantitative survey, as well as by qualitative data collected via in-depth interviews (n=20) and focus group discussions (n=4 groups, 5-10 women each). Feasibility will be assessed by the proportion of women retained in the study, the mean number of missed visits, the proportion of planned urine assessments completed, and messages delivered, while in-depth interviews with providers (n=8) will explore the ease of administering the urine test. Tenofovir levels in hair will serve as long-term adherence metrics. A linear mixed-effects model will estimate the effect of the intervention versus standard of care on logarithmically transformed levels of tenofovir in hair. RESULTS This study has been funded by the National Institute of Health, approved by the Kenya Medical Research Institute Institutional Review Board, and will commence in June 2020. CONCLUSIONS A novel urine assay to measure and deliver information on adherence to PrEP in real-time will be tested for the first time in this trial planned among women on PrEP in Kenya. Study findings will inform a larger-scale trial assessing the impact of real-time adherence monitoring/feedback on HIV prevention. Improving adherence to PrEP will have long-term implications for efforts to end the HIV epidemic worldwide. CLINICALTRIAL ClinicalTrials.gov NCT03935464; https://clinicaltrials.gov/ct2/show/NCT03935464 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/15029

High residual inflammation despite HIV viral suppression: Lessons learned from real‐time adherence monitoring among people with HIV in Africa

HIV Medicine ◽  
2021 ◽  
Author(s):  
Jose R. Castillo‐Mancilla ◽  
Nicholas Musinguzi ◽  
Stephen Asiimwe ◽  
Mark J. Siedner ◽  
Catherine Orrell ◽  
...  
Keyword(s):  
Real Time ◽  
Viral Suppression ◽  
Lessons Learned ◽  
Hiv Viral Suppression ◽  
Adherence Monitoring

scholarly journals Returning of antiretroviral medication dispensed over a period of 8 months suggests non-adherence despite full adherence according to real time medication monitoring

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Kennedy Michael Ngowi ◽  
Lydia Masika ◽  
Furaha Lyamuya ◽  
Eva Muro ◽  
Blandina T. Mmbaga ◽  
...  
Keyword(s):  
Viral Load ◽  
Real Time ◽  
Self Report ◽  
Hiv Care ◽  
Trial Participation ◽  
Hiv Viral Load ◽  
Antiretroviral Medication ◽  
Medication Monitoring ◽  
Load Monitoring ◽  
Pill Counts

Abstract Real-time medication monitoring (RTMM) may potentially enhance adherence to antiretroviral treatment (ART). We describe a participant in an ongoing trial who, shortly after completing trial participation, died of cryptococcal meningitis despite high levels of adherence according to self-report, pill-counts and RTMM (> 99%). However, she evidenced consistently high HIV viral load throughout the 48-week study follow-up. Subsequently, her relatives unsolicitedly returned eight months’ dispensed ART medication that she was supposed to have taken. This brief report illustrates the challenges of adherence measurements including RTMM, and reinforces the need to combine adherence assessments with viral load monitoring in HIV care.

scholarly journals Video chat technology to remotely quantify dietary, supplement and medication adherence in clinical trials

2016 ◽  
Vol 116 (9) ◽  
pp. 1646-1655 ◽  
Author(s):  
Courtney M. Peterson ◽  
John W. Apolzan ◽  
Courtney Wright ◽  
Corby K. Martin
Keyword(s):  
Medication Adherence ◽  
Online Survey ◽  
Self Report ◽  
Rater Agreement ◽  
Monitoring Methods ◽  
Video Chat ◽  
Pill Counts ◽  
Survey Results ◽  
Adherence Monitoring ◽  
Study Participants

AbstractWe conducted two studies to test the validity, reliability, feasibility and acceptability of using video chat technology to quantify dietary and pill-taking (i.e. supplement and medication) adherence. In study 1, we investigated whether video chat technology can accurately quantify adherence to dietary and pill-taking interventions. Mock study participants ate food items and swallowed pills, while performing randomised scripted ‘cheating’ behaviours to mimic non-adherence. Monitoring was conducted in a cross-over design, with two monitors watching in-person and two watching remotely by Skype on a smartphone. For study 2, a twenty-two-item online survey was sent to a listserv with more than 20 000 unique email addresses of past and present study participants to assess the feasibility and acceptability of the technology. For the dietary adherence tests, monitors detected 86 % of non-adherent events (sensitivity) in-person v. 78 % of events via video chat monitoring (P=0·12), with comparable inter-rater agreement (0·88 v. 0·85; P=0·62). However, for pill-taking, non-adherence trended towards being more easily detected in-person than by video chat (77 v. 60 %; P=0·08), with non-significantly higher inter-rater agreement (0·85 v. 0·69; P=0·21). Survey results from study 2 (n 1076 respondents; ≥5 % response rate) indicated that 86·4 % of study participants had video chatting hardware, 73·3 % were comfortable using the technology and 79·8 % were willing to use it for clinical research. Given the capability of video chat technology to reduce participant burden and outperform other adherence monitoring methods such as dietary self-report and pill counts, video chatting is a novel and promising platform to quantify dietary and pill-taking adherence.

scholarly journals Feasibility and Acceptability of Real-Time Antiretroviral Adherence Monitoring among Depressed Women Living with HIV in the Deep South of the US

2018 ◽  
Vol 23 (5) ◽  
pp. 1306-1314 ◽  
Author(s):  
Kristi Lynn Stringer ◽  
Andres Azuero ◽  
Corilyn Ott ◽  
Christina Psaros ◽  
Christina H. Jagielski ◽  
...  
Keyword(s):  
Real Time ◽  
Deep South ◽  
Antiretroviral Adherence ◽  
Women Living With Hiv ◽  
The Us ◽  
Adherence Monitoring ◽  
Living With Hiv

scholarly journals Real-time electronic adherence monitoring plus follow-up improves adherence compared with standard electronic adherence monitoring

AIDS ◽  
2017 ◽  
Vol 31 (1) ◽  
pp. 169-171 ◽  
Author(s):  
Jessica E. Haberer ◽  
Nicholas Musinguzi ◽  
Alexander C. Tsai ◽  
Yap Boum ◽  
Bosco M. Bwana ◽  
...  
Keyword(s):  
Real Time ◽  
Adherence Monitoring

System for integrated adherence monitoring: Real-time non-adherence risk assessment in pediatric kidney transplantation

2012 ◽  
Vol 16 (4) ◽  
pp. 329-334 ◽  
Author(s):  
Ahna L. H. Pai ◽  
Joseph Rausch ◽  
Alayna Tackett ◽  
Keith Marsolo ◽  
Dennis Drotar ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Kidney Transplantation ◽  
Real Time ◽  
Pediatric Kidney Transplantation ◽  
Adherence Monitoring

scholarly journals Implementation of a Real-Time Medication Intake Monitoring Technology Intervention in Community Pharmacy Settings: A Mixed-Method Pilot Study

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 105
Author(s):  
Sadaf Faisal ◽  
Jessica Ivo ◽  
Ryan Tennant ◽  
Kelsey-Ann Prior ◽  
Kelly Grindrod ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Technology Acceptance ◽  
Real Time ◽  
Mixed Method ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Pharmacy Staff ◽  
Medication Intake ◽  
System Usability Scale ◽  
Adherence Monitoring

Innovative dispensing products offering real-time medication intake monitoring are being developed to address medication non-adherence. However, implementation of these interventions within the workflow of a community pharmacy is unknown. The purpose of this study was to explore factors affecting implementation of a real-time adherence-monitoring, multidose-dispensing system in community pharmacies. A mixed-method study was conducted with pharmacy staff, who packaged and dispensed medications in smart multidose packages and monitored real-time medication intake via web-portal. Pharmacy staff participated in semi-structured interviews. The Technology Acceptance Model, Theory of Planned Behaviour and Capability, Opportunity, Motivation, Behaviour Model informed the interview guide. Interview transcripts were analyzed thematically and findings were mapped back to the frameworks. The usability was assessed by the System Usability Scale (SUS). Three pharmacists and one pharmacy assistant with a mean of 19 years of practice were interviewed. Three themes and 12 subthemes were generated. Themes included: pharmacy workflow factors, integration factors, and pharmacist-perceived patient factors. The mean SUS was found to be 80.63. Products with real-time adherence monitoring capabilities are valued by pharmacists. A careful assessment of infrastructure—including pharmacy workload, manpower and financial resources—is imperative for successful implementation of such interventions in a community pharmacy setting.

Review of glaucoma medication adherence monitoring in the digital health era

2021 ◽  
pp. bjophthalmol-2020-317918
Author(s):  
Alaa Erras ◽  
Bita Shahrvini ◽  
Robert N Weinreb ◽  
Sally L Baxter
Keyword(s):  
Intraocular Pressure ◽  
Medication Adherence ◽  
Real Time ◽  
Patient Adherence ◽  
Digital Health ◽  
Glaucoma Medication ◽  
Medication Usage ◽  
Adherence Monitoring

Current glaucoma treatments aim to lower intraocular pressure, often with topical ocular hypotensive medications. Unfortunately, the effectiveness of these medications depends on sustained patient adherence to regimens which may involve instilling multiple medications several times daily. Patient adherence to glaucoma medications is often low. Recent innovations in digital sensor technologies have been leveraged to confirm eyedrop medication usage in real-time and relay this information back to providers. Some sensors have also been designed to deliver medication reminders and notifications as well as assist with correct eyedrop administration technique. Here, we review recent innovations targeted at improving glaucoma medication adherence and discuss their limitations.

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