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Talking device keeps HIV patients on the straight and narrow

Sometimes the simplest things can make a dramatic difference in medicine. Johns Hopkins researchers report that a portable device that's "a cross between a pager and your own mother" can, within half a year, lead to a significant drop in the amount of virus HIV patients carry in their blood or spinal fluid.

The device is not a new therapy: It's an electronic gadget that verbally reminds patients burdened with a complex schedule of anti-AIDS medications when to take pills and what side effects to watch out for. Taking the right dose of the right pills at the right time adherence is a major problem in a disease where patients may take dozens of medications a week, the researchers say.

The pocket-size device which Hopkins researchers call DMAS, for Disease Management Assistance System, and the inventor has named "Jerry the Pharmacist" has proved especially helpful for a subgroup of study patients with mild-to-moderate memory problems brought on by the disease. "These patients have the greatest difficulty holding to a therapy schedule which ordinarily could keep the disease at bay," says lead researcher Justin C. McArthur, M.D. "Now we see that a little electronic help can substantially improve compliance."

The scientists presented early study results at last month's Conference on Retrovirus and Opportunistic Infections held in Chicago.

Of the 19 subjects out of a targeted 86 who've completed the half-year trial, those on DMAS stuck with their therapy, on average, 11 percent more often than those who heard a monthly half-hour pep talk on how and why to use their medications. Many of the DMAS patients had compliance ratings of 90 percent or higher, confirmed by a backup system using microchip-containing pill bottles that self-report when they're opened.

The DMAS patients, all on a complex regimen of at least three anti-HIV drugs, also experienced an average 10-fold drop in viral presence in their blood or spinal
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Contact: Marjorie Centofanti
mcentofanti@jhmi.edu
410-955-8725
Johns Hopkins Medical Institutions
14-Mar-2001


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