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First published September 23, 2002 as JAMIA PrePrint; doi:10.1197/jamia.M1047
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Journal of the American Medical Informatics Association 10:11-15 (2003)
© 2003 American Medical Informatics Association

Implementation Brief

A Two-way Messaging System to Enhance Antiretroviral Adherence

Peter J. Dunbar, MB, ChB, MS, David Madigan, PhD, Lisa A. Grohskopf, MD, MPH, Debra Revere, MA, MLIS, Jane Woodward, PharmD, James Minstrell, Pamela A. Frick, PharmD, MPH, Jane M. Simoni, PhD and Thomas M. Hooton, MD

Affiliations of the authors: Department of Anesthesiology, University of Washington, Seattle, Washington (PJD); Department of Statistics, University of Washington, Seattle, Washington (DM); Department of Medicine, University of Washington, Seattle, Washington (LAG, TMH); Department of Health Sciences Libraries, University of Washington, Seattle, Washington (DR); Department of Pharmacy, University of Washington, Seattle, Washington (JW, PAF); Talaria, Inc., Seattle, Washington (JM); Department of Psychology, University of Washington, Seattle, Washington (JMS).

Correspondence and reprint requests: Jane M. Simoni, PhD, Department of Psychology, University ofWashington, Box 351525, Seattle, WA 98105-1525; e-mail: <jsimoni{at}u.washington.edu>.

Failure to adhere to complex antiretroviral regimens can lead to resistance and treatment failure among HIV-positive persons. In this study of the feasibility of an automated two-way messaging system to improve adherence, participants received multiple short daily messages designed to remind, educate, encourage adherence, and solicit responses concerning side effects and self-reported adherence. Twenty-five participants remained in the study for a median of 208 days, receiving 17,440 messages and replying to 14,677 (84%). Participants reported missing one or more doses on 36% of 743 queries and reported medication side effects on 26% of 729 queries. Participants expressed high satisfaction with the messaging system and reported that it helped with medication adherence. The study suggests that it is feasible to use an automated wireless two-way messaging system to communicate with HIV-positive patients over an extended period of time.




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