Medication Adherence and Outcomes Among Patients in United States With HIV

Not Applicable

Completed

Brief Summary: With support from the NIH, this pilot study will assess the feasibility of using wireless devices and financial incentives to motivate medication adherence among HIV-positive adults in the U.S., focusing on those with non-suppressed viral loads.

While daily lotteries using wireless devices may have great potential for improving adherence to ART regimens, substantial questions exist as to whether it is: 1) possible to achieve high rates of uptake for a pilot offering wireless devices to high-risk populations; 2) achieve high rates of sustained engagement.

Detailed Description: The goal of this study is to explore the feasibility of using wireless devices and financial incentives to motivate medication adherence among high-risk HIV positive patients. By partnering with the Drexel Partnership Comprehensive Care Clinic at Drexel University, the investigators will be able to identify such patients using clinic patient data, use clinic and physician communication channels to enroll them, and maintain high levels of ongoing participation through the use of incentives. The aim is to improve antiretroviral medication adherence among high-risk HIV positive patients by providing patients with a AdhereTech device (electronic pill bottle), daily adherence notifications tracked by the Way to Health platform, as well as daily lotteries and financial incentives. Upon completion, this study will answer questions important to the feasibility of conducting well-powered randomized controlled trials to improve adherence among HIV patients within the U.S. who have sub-optimal adherence.

Recruitment & Eligibility

Inclusion Criteria

Diagnosis of HIV, established in 2017 or earlier
Patients at least 18 years of age or older
Currently prescribed first or second line ART medications
Non-suppressed viral loads, with two consecutive non-suppressed viral loads (VL>400 copies/ml) for the past two lab readings.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
adherence based financial incentives	Medication adherence and financial incentives	Participants randomized to this arm will receive an electronic pill bottle, AdhereTech. The AdhereTech bottle will be remotely monitored by the Way to Health platform. Participants will be randomly assigned a 2-digit number to be used as part of the lottery-based engagement incentives in which eligibility to win will be conditional on medication adherence. Participants will also be eligible for a financial bonus if participant's viral load is suppressed at the end of the intervention period. Participants will also receive an enrollment incentive and an incentive to complete a lab visit at the end of the intervention period.

Primary Outcome Measures

Name	Time	Method
Number of patients with viral suppression	approximately 3 months after enrollment	viral load less than 400

Secondary Outcome Measures

Name	Time	Method
viral suppression by arm	approximately 3 months after enrollment	viral load less than 400
medication adherence by arm	approximately 3 months after enrollment	electronic pill bottle openings by day
Recruitment rates by arm	approximately 3 months after enrollment
Percent of patients that use electronic pill bottle	approximately 3 months after enrollment
Attrition rates by arm	approximately 3 months after enrollment
number of clinic visits by arm	approximately 3 months after enrollment
Completion rates of lab visit by arm	approximately 3 months after enrollment

Locations (1): Drexel University
🇺🇸
Philadelphia, Pennsylvania, United States

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