Kenya: Mobile Phone Technologies Improve Adherence to Antiretroviral Treatment in a Resource-Limited Setting -- A Randomized Controlled Trial of Text Message Reminders

Noting the "limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy," the current study assessed the efficacy of short message service (SMS) ART adherence reminders among patients attending a rural clinic in Kenya.

Enrollees -- 431 adults who had initiated ART within three months -- were randomly assigned to a control group or one of four SMS reminder interventions. Intervention group participants received SMS reminders that were either short or long and sent daily or weekly. Adherence was measured using the medication event monitoring system. Adherence exceeding 90 percent during each 12-week analysis period and the 48-week study period was the primary outcome; the secondary outcome was treatment interruptions of 48 hours or more.

Intention-to-treat analysis showed 53 percent of participants receiving weekly SMS reminders achieved adherence of at least 90 percent during the 48 weeks, compared with 40 percent of control group participants (p=0.03). In addition, those in the weekly reminder group were significantly less likely to experience treatment interruptions exceeding 48 hours during the study follow-up than participants in the control group (81 percent vs. 90 percent, p=0.03).

"These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings," the study authors concluded.

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