Efetividade de uma intervenção educativa por telefone na adesão ao tratamento antirretroviral e no estilo de vida de pessoas vivendo com HIV

Abstract

This study evaluated the effectiveness of a phone intervention in antiretroviral adherence and in the lifestyle of people living with HIV. An open and prospective clinical trial was conducted with 164 patients from two specialized care services in Fortaleza, Ceará, between August 2016 and July 2017. Participants were divided into two groups: a) Intervention: received the usual care of the service and individual messages sent via the WhatsApp mobile application (n=83) and b) Control: received only the usual care of the service (n=81). The groups were followed up for four months, with the messages previously submitted to the validation of content by experts and sent fortnightly. The measurements of the variables happened in two moments (T0-baseline, T1-four months), using the instruments: a) Sociodemographic and clinical characterization form for people with HIV/AIDS; b) Questionnaire to assess adherence to antiretroviral treatment (CEAT-VIH) and c) Individual lifestyle profile instrument. Satisfaction in relation to the intervention was measured by the Satisfaction Scale for Management of Automated Disease by Telephone. The data were compiled and analyzed in SPSS® software version 23.0. The homogeneity in the distribution of the variables between the groups was measured by Fisher's test for the categorical variables and the Kruskal-Wallis test in the case of continuous variables. The technique Generalized Linear Models for data in repeated measures was used in order to evaluate the effects of the educational intervention on adherence to antiretroviral and lifestyle. Statistical significance was assumed when the p value was <0,10 (10%), with a confidence interval of 90%. At the baseline, there was a predominance of the 30 to 49 year old male, single marital status, income ≤2 minimum wages, active occupational status and schooling ≤12 years. The mean time of diagnosis was 2,9 years (± 0,6), with a predominance of time ≤3 years, with the majority having an undetectable viral load and a CD4 + lymphocyte count of ≥350 cells/ mm3. In both groups, adequate antiretroviral adherence and inadequate lifestyle prevailed, and homogeneity was identified in relation to most sociodemographic and clinical characteristics, as well as those related to adherence to antiretroviral and lifestyle. At the time T1, there was a statistically significant difference in the proportion of people with adequate adherence in the intervention group (p=0,069), as well as in the proportion of participants with no adverse effects associated with antiretrovirals (p=0,066). Despite the absence of significant effects on lifestyle, it was observed that after four months in both groups there was an increase in the proportion of people who practiced physical activity (p =0,031) and a decrease in the number of people consuming alcoholic beverages (p=0,013). There was good acceptance and satisfaction regarding follow-up, with strengthening of the link and instant communication with the patient. The thesis that "The use of a telephone educational intervention improve the adherence to antiretroviral treatment, but has no impact on the lifestyle ".