Coming 2014: EVERY DOSE EVERY DAY e-Learning Toolkit - HIV Medication Adherence Strategies to Improve Health Outcomes and Reduce the Risk of HIV Transmission
Adherence to anti-retroviral therapy (ART) is critical to the success of HIV treatment and treatment as prevention. However, the benefits of ART can be realized only by those individuals who are tested, diagnosed, timely linked to medical care, and start and adhere to ART to achieve viral suppression. In April 2011, eight individual and group-level evidence-based interventions to support HIV medication adherence were reviewed and identified as “good-evidence” by the Centers for Disease Control & Prevention (CDC) Prevention Research Synthesis Project. The Capacity Building Branch selected four of the eight medication adherence interventions to be translated into an e-learning training toolkit for clinical and non-clinical HIV providers who serve persons living with HIV (PLWH). A fifth intervention, Pager messaging, was selected to be updated to a mobile application. These adherence interventions showed efficacy in improving either medication adherence and/or viral load among either ART naïve or ART experienced patients.
View Table 1. Brief description of the 4 evidence-based HIV medication adherence strategies selected for translation into e-learning trainings for HIV providers.
The 4 adherence strategies can be delivered by a variety of HIV providers, including medical providers, licensed social workers, HIV case managers, health educators and/or peers. The following table provides examples of provider types and settings best suited for each strategy.
View Table 2. HIV Adherence Strategy by Appropriate Provider Type and Setting
Every Dose Every Day Mobile Application
The EVERY DOSE EVERY DAY (E2D2) mobile application (app) builds on the Pager Messaging intervention by assisting people living with HIV with dose, refill, and medical appointment reminders. Additionally, the app features lab tracking (e.g., viral load and CD4 count) to help the user understand how their HIV treatment regimen supports better health. The user may input important contact information of their health care team. There is also a feature that allows the user to upload a “Reason Photo”, which can serve as an inspirational reminder of why taking your HIV medication every day is important. The user may log reasons for missing a dose and information about a particular dose in the “dose notes” feature for their medications. Dose notes may include information about side effects or whether a medication needs to be taken with or without food. This information may be useful in discussing adherence challenges with their medical provider. The mobile app can be used alone or in combination with any of the 4 medication adherence strategies.
In 2014, CBB will launch this e-learning training toolkit for HIV providers on www.effectiveinterventions.org. The interactive and media rich training will include the following topics:
- Benefits of ART adherence
- Overview of each adherence strategy
- Theoretical basis
- Key players and staff roles and responsibilities
- Overview of session content
- Strategy in action (e.g., videos of sessions)
- Pre-implementation activities
- Integrating the strategy into practice
- Additional resources (e.g., downloadable tip sheets, comprehensive implementation materials, consumer materials to support adherence, and information about requesting technical assistance and capacity building)
For additional information on CDC’s medication adherence strategies, please see the Compendium of Evidence-Based HIV Behavioral Interventions: Medication Adherence Chapter