Barriers to and Facilitators of HIV-Positive Patients' Adherence to Antiretroviral Treatment Regimens

Roberts, Kathleen Johnston

doi:10.1089/108729100317948

Cited by 122 publications

(99 citation statements)

References 11 publications

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“…Part of the discussions as to the reason for this was that the flow referred patients out of the facility with little information about their conditions and what to expect. A lack of patient knowledge regarding their treatment and care has been mentioned in many studies as critical barriers to retention in care [11][12][13]. In particular, PLHIV at our participatory assessments mentioned difficulty in understanding their treatment, as a barrier to retention and adherence.…”

Section: Changing the Patient Flowmentioning

confidence: 86%

A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone

Ameyan¹,

Kamara²,

Sesay³

et al. 2017

J AIDS Clin Res

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The bottom line for any successful HIV program is adherence to therapy and retention in care with the subsequent benefit of achieving undetectable viral levels. Research has shown that poor retention in care for HIV infection has a negative impact on survival and health outcomes. This study aimed to improve retention in care at a secondary health in Freetown, Sierra Leone through a participatory approach that involved health workers and support groups. Our interventions included implementing a participatory needs assessment, reorganising the patient flow, improving communication between health workers and people living with HIV/AIDS (PLHIV), trainings and capacity building and improving the content of support group meetings. The baseline period was from June 2012 to June 2013 while the post intervention period was from June 2013 to June 2014. At baseline, a total of 47 patients were newly diagnosed out of which 19 were male and 28 were female. The median age was 32. Twenty were single, 18 married, 7 widowed and one divorced with one confirmed dead. In all, 15 were retained in care while 31 were lost to follow up. Our baseline retention was therefore 33%. Post intervention, a total of 54 patients was newly diagnosed out of which 48 were female and six were male. The median age was 29. Twenty were single, 27 married and 7 widowed. Eleven were confirmed dead and 1 asked to be transferred to a nearby facility due to reasons of distance. Thirty nine were retained in care while three were lost to follow up. Our baseline retention was therefore 93%. The results therefore showed that retention in care improved from 33% to 93% over a 6 month period. We conclude that while there are generic interventions that could be applied at program level to improve retention in care, interventions need to be context specific and fully participatory to cater to the multi-pronged yet unique peculiarities of every setting.

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Section: Changing the Patient Flowmentioning

confidence: 86%

A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone

Ameyan¹,

Kamara²,

Sesay³

et al. 2017

J AIDS Clin Res

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“…Social support is seen as an important factor impacting on HIV patients adherence to cART [4,[33][34][35][36]. Nevertheless, only five PSPs were included in this pilot study.…”

Section: Social Supportmentioning

confidence: 99%

Antiretroviral adherence program in HIV patients: a feasibility study in the Swiss HIV Cohort Study

Krummenacher¹,

Cavassini

Bugnon

et al. 2010

Pharm World Sci

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The encountered difficulties rely on the implementation, i.e., on the program and the health care system levels rather than on the patient level. Implementation needs to be evaluated further; to be feasible a new adherence program needs to fit into the daily routine of the centre and has to be supported by all trained healthcare providers. However, this study shows that patients' adherence behavior evolved differently in both groups; it decreased more quickly over time in the control than in the intervention group. RCTs are eventually needed to assess the clinical impact of such an adherence program and to verify whether skilled pharmacists can ensure continuity of care for HIV outpatients.

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“…Barriers are defined, for the purposes of this study, as factors that have the potential to interfere with endocrine therapy adherence [16][17][18][19]. Barriers in the cognitive domain include thoughts about the inefficacy of the treatment or the inconvenience of taking a medication daily, for example.…”

mentioning

confidence: 99%

Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer

Bright

Petrie

Partridge

et al. 2016

Breast Cancer Res Treat

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The treatment of chronic illness, and the prevention of disease progression and recurrence, often involve long-term adherence to prescription medications in breast cancer. Despite the survival benefit of endocrine therapies, nonadherence remains high. In this study, we examined barriers to and facilitators of endocrine therapy adherence among women with breast cancer (n = 1371). Participants currently taking tamoxifen or aromatase inhibitors were recruited from Dr. Susan Love Research Foundation's Army of Women(®) Registry. Participants responded online to open-ended and close-ended questions about thoughts, feelings, and behaviors relevant to endocrine therapy. Two weeks later, women were invited to complete a second online questionnaire regarding current endocrine therapy adherence. Approximately one-third (36 %) of participants reported the presence of factors that make endocrine therapy difficult; reporting any barrier to medication adherence was significantly associated with nonadherence (P < 0.001). In addition, 31 % of women used one or more strategies to maintain their motivation to adhere and the use of cognitive self-talk (e.g., thoughts regarding endocrine therapy efficacy) was related to higher adherence. Hierarchical linear regressions revealed a significant behavioral barrier × behavioral facilitator interaction (P < 0.05); participants who endorsed a behavioral barrier in the absence of a behavioral facilitator reported the lowest adherence. Findings suggest that a sizeable minority of women face barriers to taking endocrine therapy, which are associated with nonadherence.

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Barriers to and Facilitators of HIV-Positive Patients' Adherence to Antiretroviral Treatment Regimens

Cited by 122 publications

References 11 publications

A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone

A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone

Antiretroviral adherence program in HIV patients: a feasibility study in the Swiss HIV Cohort Study

Barriers to and facilitative processes of endocrine therapy adherence among women with breast cancer

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