{
    "abstract": "Universal antiretroviral therapy (ART) has led to improved treatment outcomes in persons living with HIV. Adherence to ART is required to achieve viral suppression. Real-time medication monitoring (RTMM)-based digital adherence tools (DATs) could be effective in improving ART adherence and viral suppression in persons living with HIV.\nThe primary and secondary objectives of this review were to assess the effect of RTMM-based DATs on improving ART adherence and viral load suppression.\nWe searched MEDLINE, Embase, and Global Health for publications published through October 11, 2022. Narrative synthesis and random effects meta-analyses were conducted to synthesize the results.\nOf 638 papers identified, 8 were included. Six studies were randomized controlled trials (RCTs), and 2 were cohort studies. Two studies, an RCT in China (mean adherence: 96.2% vs 89.1%) and a crossover cohort study in Uganda (mean adherence: 84% vs 93%), demonstrated improved ART adherence. No studies demonstrated improved viral suppression. In the meta-analyses, we estimated that RTMM-based digital adherence tools had a statistically insignificant small positive effect on ART adherence and viral suppression with a standardized mean difference of 0.1922 [95% CI: -0.0268 to 0.4112, P-value: 0.0854] and viral suppression with an odds ratio of 1.3148 [95% CI: 0.9199 to 1.8791, P-value: 0.1331].\nOur meta-analyses found that RTMM-based DATs did not have a significant effect on ART adherence and viral suppression. However, due to few published studies available, heterogeneity of target populations, intervention designs, and adherence measurement instruments, more data are required to provide conclusive evidence.",
    "authors": [
        {
            "affiliation": "Department of Global Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.\nAmsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.\nHelse Nord Tuberculosis Initiative, Kamuzu University of Health Sciences, Blantyre, Malawi.",
            "firstname": "Takondwa Charles",
            "initials": "TC",
            "lastname": "Msosa"
        },
        {
            "affiliation": "Department of Global Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.\nKilimanjaro Clinical Research Institute, Moshi, Tanzania.",
            "firstname": "Iraseni",
            "initials": "I",
            "lastname": "Swai"
        },
        {
            "affiliation": "Radboud University Medical Center, Department of Pharmacy, Research Institute for Medical Innovation, Nijmegen, the Netherlands; and.",
            "firstname": "Rob",
            "initials": "R",
            "lastname": "Aarnoutse"
        },
        {
            "affiliation": "Department of Global Health, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.",
            "firstname": "Tobias F",
            "initials": "TF",
            "lastname": "Rinke de Wit"
        },
        {
            "affiliation": "Kilimanjaro Clinical Research Institute, Moshi, Tanzania.",
            "firstname": "Kennedy",
            "initials": "K",
            "lastname": "Ngowi"
        },
        {
            "affiliation": "Helse Nord Tuberculosis Initiative, Kamuzu University of Health Sciences, Blantyre, Malawi.",
            "firstname": "Chisomo",
            "initials": "C",
            "lastname": "Msefula"
        },
        {
            "affiliation": "Helse Nord Tuberculosis Initiative, Kamuzu University of Health Sciences, Blantyre, Malawi.",
            "firstname": "Marriott",
            "initials": "M",
            "lastname": "Nliwasa"
        },
        {
            "affiliation": "Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.\nKilimanjaro Clinical Research Institute, Moshi, Tanzania.\nInstitute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.",
            "firstname": "Marion Sumari-de",
            "initials": "MS",
            "lastname": "Boer"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 The Author(s). Published by Wolters Kluwer Health, Inc.",
    "doi": "10.1097/QAI.0000000000003449\n10.1101/2023.03.22.23287383",
    "journal": "Journal of acquired immune deficiency syndromes (1999)",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-07-10",
    "pubmed_id": "38985562\n37213438\n31747358\n28043170\n22411426\n29480831\n30633041\n20048268\n10877736\n31343455\n27082595\n27660234\n34903209\n34635018\n31886271\n36178915\n36053049\n25695494\n26218411\n27146828\n33871411\n25886927\n24577868\n26604004\n21448728\n23751260\n37851616\n23956851\n25043931\n19622552\n31462531\n31621641\n26760452\n27835622\n35704124\n32424549",
    "results": "Of 638 papers identified, 8 were included. Six studies were randomized controlled trials (RCTs), and 2 were cohort studies. Two studies, an RCT in China (mean adherence: 96.2% vs 89.1%) and a crossover cohort study in Uganda (mean adherence: 84% vs 93%), demonstrated improved ART adherence. No studies demonstrated improved viral suppression. In the meta-analyses, we estimated that RTMM-based digital adherence tools had a statistically insignificant small positive effect on ART adherence and viral suppression with a standardized mean difference of 0.1922 [95% CI: -0.0268 to 0.4112, P-value: 0.0854] and viral suppression with an odds ratio of 1.3148 [95% CI: 0.9199 to 1.8791, P-value: 0.1331].",
    "title": "The Effect of Real-Time Medication Monitoring-Based Digital Adherence Tools on Adherence to Antiretroviral Therapy and Viral Suppression in People Living With HIV: A Systematic Literature Review and Meta-Analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885062ca020>"
}