Effect of Counselling and Reminder Text Messages Follow-Up on Adherence to Antiretroviral Therapy in Hajiya Gambo Sawaba General Hospital, Zaria, Nigeria

Poor adherence is a major challenge to antiretroviral therapy. It is now recommended that patients have 95% adherence in order to maintain sufficient suppression of viral replication and prevent the emergence of resistance. It is therefore of paramount importance device methods to improve patient adherence. The use of mobile phone calls and text messages are being explored in improving adherence. In this study, the effect of counselling plus reminder text messages were determined. A total of 132 patients was allocated into an intervention and control groups. Both groups were given additional adherence counselling at the beginning of the study and at every clinic visit. The intervention group was also sent reminder text messages for a period of 24 weeks. The CD4 count of all patients was recorded at the start of the study, then the final reading after the follow-up period. The difference in the increase in the CD4 counts between the two groups was compared to find out the difference. Additionally, patients’ self-report of adherence was compared between the two groups. Patients with 95% and above adherence were classified as adherent, while those with less than 95% non-adherent. It was found that the patients who received reminder text messages in addition to counselling had significantly higher mean percentage increase in CD4 count (36.7%) compared to the control group (19.12%), which received counselling only (p=0.007) However, using self-report form, there was no statistical significant difference in the level of adherence between intervention group and control group. It was therefore concluded that regular counselling and reminder text messages have improved adherence to antiretroviral therapy.