The effectiveness of SMART Care case management program on treatment adherence among HIV patients at Napha Clinic, Bueng Kan Hospital
DOI:
https://doi.org/10.14456/taj.2026.7Keywords:
case management, treatment adherence, HIV patients, digital healthAbstract
This study employed a one-group pretest-posttest pre-experimental design to examine the effectiveness of the SMART Care case management program on treatment adherence, antiretroviral medication adherence, viral load, and CD4 levels among HIV patients. The sample consisted of 36 HIV patients with viral load levels greater than 50 copies/mL who were receiving treatment at Napha Clinic, Bueng Kan Hospital. The intervention was the SMART Care case management program, comprising (1) self-management support (S), (2) a monitoring system (M), (3) an application-based reminder system (A), (4) a responsive care team (R), and (5) the use of technology (T). All activities were conducted over six sessions between January and June 2025. Data were collected using a general information questionnaire, a treatment adherence questionnaire, medication intake records, and laboratory result records. Data were analyzed using the paired t-test and the Wilcoxon signed-rank test. The results showed that, after the intervention, overall treatment adherence significantly increased (p<0.05), including antiretroviral medication adherence, appointment keeping, and compliance with healthcare recommendations (p<0.05). Antiretroviral medication adherence increased from 91.99% to 97.15% (p<0.05). Viral load significantly decreased (p<0.05), with all patients achieving viral load levels below 50 copies/mL, while CD4 levels showed no significant difference (p>0.05). In conclusion, the SMART Care case management program was effective in promoting treatment adherence, particularly antiretroviral medication adherence, resulting in significantly improved viral control. Therefore, it may be suitable for application in HIV care.
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