Adherence to Antiretroviral Therapy Assessed by Unannounced Pill Counts Conducted by Telephone

Kalichman, Seth C.; Amaral, Christina M.; Stearns, Heidi; White, Denise; Flanagan, Jody; Pope, Howard; Cherry, Chauncey; Cain, Demetria; Eaton, Lisa A.; Kalichman, Moira O.

doi:10.1007/s11606-007-0171-y

Cited by 110 publications

(139 citation statements)

References 18 publications

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“…Unannounced pill counts are reliable and valid in assessing HIV treatment adherence when conducted in participants' homes 14 and on the telephone. 16,17 Participants were provided with a cell phone that restricted service for project contacts and emergency use (e.g., 911). Following an office-based training in the pill-counting procedure, participants were called at unscheduled times by a phone assessor.…”

Section: Methodsmentioning

confidence: 99%

Health and Treatment Implications of Food Insufficiency among People Living with HIV/AIDS, Atlanta, Georgia

et al. 2010

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HIV/AIDS is concentrated among the inner-city poor and poverty may directly interfere with HIV treatment. This study examined food insufficiency in relation to HIV-related health and treatment. A sample of 344 men and women living with HIV/ AIDS in Atlanta, Georgia completed measures of food security, health, and HIV disease progression and treatment. HIV treatment adherence was monitored using unannounced pill counts. Results showed that half of people living with HIV/AIDS in this study lacked sufficient food, and food insufficiency was associated with multiple indicators of poor health, including higher HIV viral loads, lower CD4 cell counts, and poorer treatment adherence. Adjusted analyses showed that food insufficiency predicted HIV treatment non-adherence over and above years of education, employment status, income, housing, depression, social support, and non-alcohol substance use. Hunger and food insecurity are prevalent among people living with HIV/AIDS, and food insufficiency is closely related to multiple HIV-related health indicators, particularly medication adherence. Interventions that provide consistent and sustained meals to people living with HIV/AIDS are urgently needed.

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Section: Methodsmentioning

confidence: 99%

Health and Treatment Implications of Food Insufficiency among People Living with HIV/AIDS, Atlanta, Georgia

et al. 2010

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“…Unannounced pill counts are reliable and valid in assessing medication adherence when conducted in homes 20 and on the telephone. 21,22 In this study, we conducted unannounced cell-phone-based pill counts. Participants were provided with a free cell phone that restricted service for project contacts and emergency use.…”

Section: Medication Adherencementioning

confidence: 99%

Intentional Non-Adherence to Medications among HIV Positive Alcohol Drinkers: Prospective Study of Interactive Toxicity Beliefs

et al. 2012

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BACKGROUND: Antiretroviral therapy (ART) adherence is key to successful treatment of HIV infection and alcohol is a known barrier to adherence. Beyond intoxication, ART adherence is impacted by beliefs that mixing alcohol and medications is toxic. PURPOSE: To examine prospective relationships of factors contributing to intentional medication nonadherence when drinking. METHODS: People who both receive ART and drink alcohol (N=178) were enrolled in a 12-month prospective cohort study that monitored beliefs about the hazards of mixing ART with alcohol (interactive toxicity beliefs), alcohol consumption using electronic daily diaries, ART adherence assessed by both unannounced pill counts and self-report, and chart-abstracted HIV viral load. RESULTS: Participants who reported skipping or stopping their ART when drinking (N=90, 51 %) demonstrated significantly poorer ART adherence, were less likely to be viral suppressed, and more likely to have CD4 counts under 200/cc 3 . Day-level analyses showed that participants who endorsed interactive toxicity beliefs were significantly more likely to miss medications on drinking days. CONCLUSIONS: Confirming earlier cross-sectional studies, the current findings from a prospective cohort show that a substantial number of people intentionally skip or stop their medications when drinking. Interventions are needed to correct alcohol-related interactive toxicity misinformation and promote adherence among alcohol drinkers.KEY WORDS: medication adherence; alcohol use; HIV treatment beliefs.

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“…8,11 In this sample of people living with HIV who scored low on a health literacy test and were taking antiretroviral medications, the average ART adherence was 84% of pills taken as prescribed, and less than half of participants achieved the clinically meaningful cut-off of 85% adherent. 26 These levels of adherence indicate risks for treatment failure and the potential to develop HIV treatment resistant viral strains.…”

Section: Discussionmentioning

confidence: 93%

“…Unannounced pill counts are reliable and valid in assessing medication adherence when conducted in homes 24 and on the telephone with people living with HIV and lowliteracy skills. 8,25 In this study, we conducted unannounced cell-phone based pill counts. Participants were provided with a free cell phone that restricted service for project contacts and emergency use.…”

Section: Methodsmentioning

confidence: 99%

“…Studies show that low literacy predicts medication adherence over and above other well-established barriers to adherence, including substance use and depression. [6][7][8] Information resources that are associated with adherence, such as seeking health information on the Internet, 9 are less available to people with poor reading skills. In addition to not maintaining medication adherence, patients with poor literacy skills often fail to fully understand diagnostic information, health care directions, and instructions.…”

mentioning

confidence: 99%

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Requesting Help to Understand Medical Information Among People Living with HIV and Poor Health Literacy

Kalichman

Pellowski

Chen

2013

AIDS Patient Care and STDs

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Health literacy is known to influence medication adherence among people living with HIV/AIDS. People who experience difficulty reading health information may benefit from asking others to assist them with reading, interpreting, and understanding medical information. We examined medical chart-abstracted HIV viral load, medication adherence assessed by unannounced pill counts, and adherence improvement strategies among 245 individuals with lower-health literacy who do not request assistance, and 229 who do request assistance with reading and understanding health information. Participants were people living with HIV who were taking antiretroviral therapy and scored below 90% correct on a standardized test of functional health literacy. After controlling for health literacy scores, requesting informational assistance was associated with strategies used to improve adherence; individuals who asked for assistance were significantly more likely to use multiple adherence strategies. However, despite requesting informational assistance and using more adherence strategies, participants who requested informational assistance evidenced poorer treatment adherence and poorer suppression of HIV replication. Requesting assistance was more common among those with the poorest health literacy and therefore greatest challenges to adherence. People living with HIV who have poor health literacy skills may benefit from medication adherence programs and requests for assistance afford opportunities for social interventions.

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Adherence to Antiretroviral Therapy Assessed by Unannounced Pill Counts Conducted by Telephone

Cited by 110 publications

References 18 publications

Health and Treatment Implications of Food Insufficiency among People Living with HIV/AIDS, Atlanta, Georgia

Health and Treatment Implications of Food Insufficiency among People Living with HIV/AIDS, Atlanta, Georgia

Intentional Non-Adherence to Medications among HIV Positive Alcohol Drinkers: Prospective Study of Interactive Toxicity Beliefs

Requesting Help to Understand Medical Information Among People Living with HIV and Poor Health Literacy

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