手机短信提醒方式应用于艾滋病患者抗病毒治疗的研究

THE RESEARCH ABOUT REMINDING THE ACQUIRED IMMUNE DEFICIENCY SYNDROME PATIENTS WHO ARE TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY BY TELEPHONE MESSAGE

目的:探讨使用手机短信提醒干预方式配合常规的依从性教育应用于艾滋病患者高效抗反转录病毒治疗(HAART)提高患者服药依从性,从而减少治疗失败现象的发生。方法:将HAART 80例患者按就诊顺序单双数交替入选方法分为两组,对照组(40例):HAART治疗前对患者进行常规的依从性教育。干预组(40例):HAART治疗前对患者进行常规的依从性教育并由医护人员在患者需要服药的时间进行每天两次手机短信提醒。监测两组患者HAART治疗第1年的依从性和治疗失败现象;HAART的基线、1,2,3,4年分别检测CD4+及病毒载量。结果:①HAART第一年服药依从性:对照组为91.7%;干预组为99.2%,两组比较差异有统计学意义(χ2=1823.981,P<0.05)。②对照组HAART第1年死亡3例、失访2例、第2年耐药1例;第4年死亡1例,耐药1例;干预组:HAART第1年时死亡1例,4年无失访、耐药发生;两组比较差异有统计学意义(χ2=6.135,P<0.05)。结论:使用手机短信提醒干预方式配合常规的依从性教育应用于艾滋病患者HAART有助于提高患者服药依从性,从而减少艾滋病患者HAART治疗失败现象的发生。

Objective：To explore if reminding the patients by telephone message combined with conventional compliance education in the acquired immune deficiency syndrome （AIDS） patients who are treated with highly active antiretroviral therapy （HAART） can improve medication compliance, in order to reduce the rate of the treatment failure. Methods： Eighty patients with AIDS were divided into control group （ n= 40, conventional compliance education before HAART） and the intervention group （ n = 40, conventional compliance education and reminded twice by the telephone message when they must have medicine during the HAART）. The CD4＋T lymphocyte counts and HIV viral load were recorded at baseline, 1, 2, 3 and 4 years. Death, loss of follow-up, and drug resistance were defined as treatment failure. Results： The proportion of taking pills on time was 91.7% in control group, and 99.2% in intervention group （ P〈0.05）. For the control group, 3 cases were died and 2 were lost to follow-up in the fist year; 1 had drug resistance in the second year; 1 had drug resistance and 1 was died in the forth year. One case in the intervention group was died in the fist year. The remaining 39 patients took medicine for four years without drug resistance. The difference was statistical significance between the two groups （ P 〈0, 05）. Conclusion： Telephone message reminding combined with conventional compliance education in the AIDS patients who were treated with HAART can improve patients medication compliance, and reduce the failure rate of the highly active antiretroviral therapy.