title: Individualized texting for adherence building (iTAB): improving antiretroviral dose timing among HIV-infected persons with co-occurring bipolar disorder.
abstract: HIV+ persons with co-occurring bipolar disorder (HIV+/BD+) have elevated rates of medication nonadherence. We conducted a 30-day randomized controlled trial of a two-way, text messaging system, iTAB (n = 25), compared to an active comparison (CTRL) (n = 25) to improve antiretroviral (ARV) and psychotropic (PSY) adherence and dose timing. Both groups received medication adherence psychoeducation and daily texts assessing mood. The iTAB group additionally received personalized medication reminder texts. Participants responded to over 90 % of the mood and adherence text messages. Mean adherence, as assessed via electronic monitoring caps, was high and comparable between groups for both ARV (iTAB 86.2 % vs. CTRL 84.8 %; p = 0.95, Cliff's d = 0.01) and PSY (iTAB 78.9 % vs. CTRL 77.3 %; p = 0.43, Cliff's d = -0.13) medications. However, iTAB participants took ARVs significantly closer to their intended dosing time than CTRL participants (iTAB: 27.8 vs. CTRL: 77.0 min from target time; p = 0.02, Cliff's d = 0.37). There was no group difference on PSY dose timing. Text messaging interventions may represent a low-burden approach to improving timeliness of medication-taking behaviors among difficult-to-treat populations. The benefits of improved dose timing for long-term medication adherence require additional investigation.
authors.affiliation: Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, 92093, USA, djmoore@ucsd.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.forename: Amelia
authors.initials: A
authors.lastname: Poquette
authors.forename: Kaitlin B
authors.initials: KB
authors.lastname: Casaletto
authors.forename: Ben
authors.initials: B
authors.lastname: Gouaux
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Montoya
authors.forename: Carolina
authors.initials: C
authors.lastname: Posada
authors.forename: Alexandra S
authors.initials: AS
authors.lastname: Rooney
authors.forename: Jayraan
authors.initials: J
authors.lastname: Badiee
authors.forename: Reena
authors.initials: R
authors.lastname: Deutsch
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.forename: Colin A
authors.initials: CA
authors.lastname: Depp
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: J Hampton
authors.initials: JH
authors.lastname: Atkinson
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000150:complications*; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D017010:Reminder Systems; D060145:Text Messaging; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents