Improving adherence to complex medical regimens through the integration of knowledge, technology and informatics


Conference Paper

About 33.3 million people were living with HIV at the end of 2009. Over the past several years a significant investment in the scale up of antiretroviral therapy (ART) has contributed to both a reduction in AIDS-related morbidity and mortality and in a decline in new HIV infection. A total of 5.2 million people in low- and middle-income countries now receive antiretroviral therapy. Within several months of initiating ART most patients become asymptomatic and then must closely adhere to unforgiving drug regimens for life. Incomplete adherence to ART regimens results in treatment failure, the emergence of drug resistance and the transmission of drug resistant virus to uninfected individuals. This requirement for lifelong regimen adherence has proven to be the Achilles' heel of antiretroviral therapy. Advances in the capability and affordability of mobile technologies present a new perspective on this paradigm. Combined with human and computer networks, mobile devices such as smart phones and tablets bring patients and providers together in previously impossible ways and may present real and lastingremedies for patient outreach and communication. In order to integrate the three major components of adherence: Information, Motivation and Behavioral Modification, we are developing open source pictographic software enabled for web and mobile platforms. We will use these tools to study ART adherence and motivation in low-literacy patients with the goal of enhancing patient comprehension and health. Cybernetic technologies utilizing mobile computing and pictogram interfaces can serve to communicate highly tailored information, evaluate regimen-specific knowledge and assess motivation and behavioral skills of patients requiring therapy. We expect this workshop will bring together all of the requisite expertise in informatics and cybernetics required to develop powerful computerized tools to ensure ART treatment success at the level of both individual patients and the population at large.

Duke Authors

Cited Authors

  • Badaro, R; Cruz, C; Garcia, R; Aronoff-Spencer, E; Kim, H; Browne, S; Schooley, RT

Published Date

  • January 1, 2012

Published In

  • 3rd International Multi Conference on Complexity, Informatics and Cybernetics, Imcic 2012 Proceedings

Start / End Page

  • 388 - 393

International Standard Book Number 13 (ISBN-13)

  • 9781936338573

Citation Source

  • Scopus