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Technology-Based Self-Care Methods of Improving Antiretroviral Adherence: A Systematic Review

Authors
Journal
PLoS ONE
1932-6203
Publisher
Public Library of Science
Publication Date
Volume
6
Issue
11
Identifiers
DOI: 10.1371/journal.pone.0027533
Keywords
  • Research Article
  • Biology
  • Microbiology
  • Virology
  • Antivirals
  • Medicine
  • Clinical Research Design
  • Systematic Reviews
  • Infectious Diseases
  • Sexually Transmitted Diseases
  • Aids
  • Viral Diseases
  • Hiv
  • Hiv Diagnosis And Management
  • Non-Clinical Medicine
  • Health Care Policy
  • Treatment Guidelines
  • Public Health
  • Behavioral And Social Aspects Of Health
Disciplines
  • Communication
  • Medicine

Abstract

Background As HIV infection has shifted to a chronic condition, self-care practices have emerged as an important topic for HIV-positive individuals in maintaining an optimal level of health. Self-care refers to activities that patients undertake to maintain and improve health, such as strategies to achieve and maintain high levels of antiretroviral adherence. Methodology/Principal Findings Technology-based methods are increasingly used to enhance antiretroviral adherence; therefore, we systematically reviewed the literature to examine technology-based self-care methods that HIV-positive individuals utilize to improve adherence. Seven electronic databases were searched from 1/1/1980 through 12/31/2010. We included quantitative and qualitative studies. Among quantitative studies, the primary outcomes included ARV adherence, viral load, and CD4+ cell count and secondary outcomes consisted of quality of life, adverse effects, and feasibility/acceptability data. For qualitative/descriptive studies, interview themes, reports of use, and perceptions of use were summarized. Thirty-six publications were included (24 quantitative and 12 qualitative/descriptive). Studies with exclusive utilization of medication reminder devices demonstrated less evidence of enhancing adherence in comparison to multi-component methods. Conclusions/Significance This systematic review offers support for self-care technology-based approaches that may result in improved antiretroviral adherence. There was a clear pattern of results that favored individually-tailored, multi-function technologies, which allowed for periodic communication with health care providers rather than sole reliance on electronic reminder devices.

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