title: Technology-based self-care methods of improving antiretroviral adherence: a systematic review.
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.
  
  
  RESULTS
  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
  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.
authors.affiliation: Department of Medicine, University of CaliforniaSan Francisco, San Francisco, California, United States of America. parya.saberi@ucsf.edu
authors.forename: Parya
authors.initials: P
authors.lastname: Saberi
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D020811:Biomedical Technology / Q000379:methods*; D006801:Humans; D010349:Patient Compliance; D011642:Publications; D036301:Qualitative Research; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents