Can a Mobile App Help With Stress Management for HIV-Related Fatigue?

People living with HIV may carry an increased risk of fatigue, depression, and anxiety because of stressors related to the illness such as managing an antiretroviral regimen, comorbidities, and other stressful life events.

To determine whether a mobile app can help manage HIV-related fatigue, investigators with the Medical University of South Carolina embarked on a feasibility study exploring the development and usability of a digital solution. Their results were presented in a late-breaking session at the Association of Nurses in AIDS Care Conference (ANAC 2019).

In an interview with Contagion® at the conference, presenting author Julie Barroso, PhD, ANP, FAAN, associate dean of faculty at Medical University of South Carolina, shared the motivation behind the app and explained where HIV-related fatigue stems from.

The project comprised 2 parts: First, the research team used Antoni’s workbook, “Cognitive Behavioral Stress Management for Individuals Living With HIV,” to develop a mHealth application that featured 10 weekly modules. Secondly, in the randomized controlled portion of the study, 30 participants were randomized to either the CBSM app or a generic healthy lifestyle app.

Investigators collected measures on HIV-related fatigue, depression, anxiety, stressful life events, CD4 count, and HIV viral load at baseline, weeks 5 and 10, and at 3 months post-study completion. The team also logged data on credibility and expectancy of the intervention, as well barriers to treatment participation, in order to evaluate the feasibility of the program.

Among participants in the study arm who completed at least 80% of the modules, the CBSM app resulted in significant changes (95% confidence interval [CI]; lower scores indicate improvement), particularly in fatigue intensity and overall fatigue-related functioning (from 64.2 to 59.7 and from 6.6 to 4.2, respectively). Significant changes were also recorded in activities of daily living (from 6.7 to 4.1), socialization (from 6.5 to 4.3), and mental functioning (from 6.6 to 4.7), as well as a reduction in number of stresses at 3 months (from 4.4 to 1.9). Participants reported strong beliefs about the efficacy of the intervention, and there were few barriers to treatment participation.

“We have proof of concept as to the feasibility, acceptability, and initial signals of efficacy for an mHealth intervention to help people with HIV-related fatigue better cope with stress and reduce their fatigue,” investigators concluded.

The study, A feasibility study to develop and test a cognitive behavioral stress management mobile health application for HIV-related fatigue, was presented Friday, November 8, 2019, at the Association of Nurses in AIDS Care Conference (ANAC 2019) in Portland, Oregon.