Skip to main content
Top
Published in: Trials 1/2009

Open Access 01-12-2009 | Study protocol

The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol

Authors: Richard T Lester, Edward J Mills, Antony Kariri, Paul Ritvo, Michael Chung, William Jack, James Habyarimana, Sarah Karanja, Samson Barasa, Rosemary Nguti, Benson Estambale, Elizabeth Ngugi, T Blake Ball, Lehana Thabane, Joshua Kimani, Lawrence Gelmon, Marta Ackers, Francis A Plummer

Published in: Trials | Issue 1/2009

Login to get access

Abstract

Background

The objectives are to compare the effectiveness of cell phone-supported SMS messaging to standard care on adherence, quality of life, retention, and mortality in a population receiving antiretroviral therapy (ART) in Nairobi, Kenya.

Methods and Design

A multi-site randomized controlled open-label trial. A central randomization centre provided opaque envelopes to allocate treatments. Patients initiating ART at three comprehensive care clinics in Kenya will be randomized to receive either a structured weekly SMS ('short message system' or text message) slogan (the intervention) or current standard of care support mechanisms alone (the control). Our hypothesis is that using a structured mobile phone protocol to keep in touch with patients will improve adherence to ART and other patient outcomes. Participants are evaluated at baseline, and then at six and twelve months after initiating ART. The care providers keep a weekly study log of all phone based communications with study participants.
Primary outcomes are self-reported adherence to ART and suppression of HIV viral load at twelve months scheduled follow-up. Secondary outcomes are improvements in health, quality of life, social and economic factors, and retention on ART. Primary analysis is by 'intention-to-treat'. Sensitivity analysis will be used to assess per-protocol effects. Analysis of covariates will be undertaken to determine factors that contribute or deter from expected and determined outcomes.

Discussion

This study protocol tests whether a novel structured mobile phone intervention can positively contribute to ART management in a resource-limited setting.

Trial Registration

Trial Registration Number: NCT00830622
Appendix
Available only for authorised users
Literature
1.
go back to reference Wood E, Hogg RS, Yip B, Harrigan PR, O'Shaughnessy MV, Montaner JS: Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 × 10(9) cells/L. Annals of internal medicine. 2003, 139: 810-816.CrossRefPubMed Wood E, Hogg RS, Yip B, Harrigan PR, O'Shaughnessy MV, Montaner JS: Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4+ cell count is 0.200 to 0.350 × 10(9) cells/L. Annals of internal medicine. 2003, 139: 810-816.CrossRefPubMed
3.
go back to reference Lester RT, Gelmon L, Plummer FA: Cell phones: tightening the communication gap in resource-limited antiretroviral programmes?. Aids. 2006, 20: 2242-2244. 10.1097/QAD.0b013e3280108508.CrossRefPubMed Lester RT, Gelmon L, Plummer FA: Cell phones: tightening the communication gap in resource-limited antiretroviral programmes?. Aids. 2006, 20: 2242-2244. 10.1097/QAD.0b013e3280108508.CrossRefPubMed
4.
go back to reference Lester R, Karanja S: Mobile phones: exceptional tools for HIV/AIDS, health, and crisis management. Lancet Infect Dis. 2008, 8: 738-739. 10.1016/S1473-3099(08)70265-2.CrossRefPubMed Lester R, Karanja S: Mobile phones: exceptional tools for HIV/AIDS, health, and crisis management. Lancet Infect Dis. 2008, 8: 738-739. 10.1016/S1473-3099(08)70265-2.CrossRefPubMed
5.
go back to reference Rosen S, Fox MP, Gill CJ: Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med. 2007, 4: e298-10.1371/journal.pmed.0040298.CrossRefPubMedPubMedCentral Rosen S, Fox MP, Gill CJ: Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med. 2007, 4: e298-10.1371/journal.pmed.0040298.CrossRefPubMedPubMedCentral
6.
go back to reference Montori VM, Permanyer-Miralda G, Ferreira-Gonzalez I, Busse JW, Pacheco-Huergo V, Bryant D, Alonso J, Akl EA, Domingo-Salvany A, Mills E, Wu P, Schunemann HJ, Jaeschke R, Guyatt GH: Validity of composite end points in clinical trials. Bmj. 2005, 330: 594-596. 10.1136/bmj.330.7491.594.CrossRefPubMedPubMedCentral Montori VM, Permanyer-Miralda G, Ferreira-Gonzalez I, Busse JW, Pacheco-Huergo V, Bryant D, Alonso J, Akl EA, Domingo-Salvany A, Mills E, Wu P, Schunemann HJ, Jaeschke R, Guyatt GH: Validity of composite end points in clinical trials. Bmj. 2005, 330: 594-596. 10.1136/bmj.330.7491.594.CrossRefPubMedPubMedCentral
7.
go back to reference Liu H, Miller LG, Hays RD, Golin CE, Wu T, Wenger NS, Kaplan AH: Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. J Acquir Immune Defic Syndr. 2006, 41: 315-322. 10.1097/01.qai.0000197071.77482.6e.CrossRefPubMed Liu H, Miller LG, Hays RD, Golin CE, Wu T, Wenger NS, Kaplan AH: Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. J Acquir Immune Defic Syndr. 2006, 41: 315-322. 10.1097/01.qai.0000197071.77482.6e.CrossRefPubMed
8.
go back to reference Little RJ, Rubin DB: Statistical Analysis with Missing Data. 2002, New York, NY: Wiley, 2 Little RJ, Rubin DB: Statistical Analysis with Missing Data. 2002, New York, NY: Wiley, 2
9.
go back to reference Reynolds NR, Testa MA, Su M, Chesney MA, Neidig JL, Frank I, Smith S, Ickovics J, Robbins GK: Telephone support to improve antiretroviral medication adherence: a multisite, randomized controlled trial. J Acquir Immune Defic Syndr. 2008, 47: 62-68. 10.1097/QAI.0b013e3181582d54.CrossRefPubMed Reynolds NR, Testa MA, Su M, Chesney MA, Neidig JL, Frank I, Smith S, Ickovics J, Robbins GK: Telephone support to improve antiretroviral medication adherence: a multisite, randomized controlled trial. J Acquir Immune Defic Syndr. 2008, 47: 62-68. 10.1097/QAI.0b013e3181582d54.CrossRefPubMed
10.
go back to reference Vidrine DJ, Arduino RC, Lazev AB, Gritz ER: A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS. Aids. 2006, 20: 253-260. 10.1097/01.aids.0000198094.23691.58.CrossRefPubMed Vidrine DJ, Arduino RC, Lazev AB, Gritz ER: A randomized trial of a proactive cellular telephone intervention for smokers living with HIV/AIDS. Aids. 2006, 20: 253-260. 10.1097/01.aids.0000198094.23691.58.CrossRefPubMed
11.
go back to reference Hardin JW: Generalized Estimating Equations. 2001, New York: Chapman and Hall/CRC Hardin JW: Generalized Estimating Equations. 2001, New York: Chapman and Hall/CRC
12.
go back to reference Diggle PJ, Liang KY, Zeger S: Analysis of Longitudinal Data. 1994, Oxford: Oxford Science Publications Diggle PJ, Liang KY, Zeger S: Analysis of Longitudinal Data. 1994, Oxford: Oxford Science Publications
Metadata
Title
The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol
Authors
Richard T Lester
Edward J Mills
Antony Kariri
Paul Ritvo
Michael Chung
William Jack
James Habyarimana
Sarah Karanja
Samson Barasa
Rosemary Nguti
Benson Estambale
Elizabeth Ngugi
T Blake Ball
Lehana Thabane
Joshua Kimani
Lawrence Gelmon
Marta Ackers
Francis A Plummer
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Trials / Issue 1/2009
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-10-87

Other articles of this Issue 1/2009

Trials 1/2009 Go to the issue