NCT03367130

Improving Clinic Attendance for Medication Collection Among HIV Positive Individuals in Nepal

Completed NA Last updated 17 September 2018

What this trial tests

NA trial testing Mobile phone reminder in HIV Infections in 468 participants. Completed in 30 June 2018.

Timeline

14 October 2017

Primary endpoint
30 June 2018

30 June 2018

Quick facts

Lead sponsor	Tokyo University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	double
Primary purpose	health services research
Enrollment	468
Start date	14 October 2017
Primary completion	30 June 2018
Estimated completion	30 June 2018
Sites	1 location across Nepal

Drugs / interventions tested

• Mobile phone reminder

Conditions studied

• HIV Infections — all drugs for HIV Infections →
• Antiretroviral Therapy — all drugs for Antiretroviral Therapy →
• HIV Seropositivity — all drugs for HIV Seropositivity →

Sponsor

Tokyo University

Who can join

18 and older, any sex, with HIV Infections or Antiretroviral Therapy. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Antiretroviral therapy (ART) has been a game changer in the context of HIV-epidemic. From 2005 to 2015, HIV-related deaths have fallen by 45% thanks to ART. However, ART's success heavily depends on HIV-positive individuals' high adherence to it. This includes clinic attendance for various purposes. It is necessary among HIV-positive individuals for their antiretroviral (ARV) pills pick up, monitoring of their treatment outcomes, and treatment of their opportunistic infections. Among them, ARV pills pick up is the major reason for the ART clinic attendance. Improving clinic attendance for pills pick up remains one of the key challenges to ART programs. The World Health Organization (WHO) recommends more than 90% on-time ARV pills pick up as per the early warning indicators of HIV-drug resistance. Among six Asian countries, none of the 1048 clinics under the study could meet the WHO target. Among HIV-positive individuals, clinic attendance for pills pick can be improved by using mobile phones. Those who receive mobile phone reminders are two times more likely to attend their clinics regularly than those who did not receive such reminders. Nepal belongs to a low-income country and is facing a similar problem, too. In 2015, approximately 39,000 people were estimated to be living with HIV and ART coverage was limited to only 31.5%. In the same year, only 32% of the HIV-positive individuals attended their clinics regularly for ARV pills pick up. Like other countries, one of the potential strategies is to use mobile phones effectively in Nepal. Mobile phones have been very widely used in Nepal. In 2016, Nepal had 27.9 million mobile phone users, against the population of 26.5 million. Under such a context, mobile phone reminders can be effective to improve clinic attendance among HIV-positive individuals. However, the effectiveness of such interventions barely remains examined by using a randomized controlled trial. This study evaluates the effectiveness of mobile phone reminder intervention on improving clinic attendance for ARV pills pick up and medication adherence among HIV-positive individuals on ART following the implementation of test and treat strategy in Nepal.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. Targeted client communication via mobile devices for improving sexual and reproductive health.
   Palmer MJ, Henschke N, Villanueva G, Maayan N, et al · · 2020 · cited 32× · PMID 32779730 · DOI 10.1002/14651858.cd013680