Influence of the number of daily pills and doses on adherence to antiretroviral treatment: a 7-year study

Arroyo, María Jesús Hernández; Figueroa, Salvador Enrique Cabrera; Correa, Rosa Sepúlveda; Merino, María Paz Valverde; Rodrigo, Ganganath; Hurlé, Alfonso Domínguez-Gil; Team, Tormes

doi:10.1111/jcpt.12343

Cited by 7 publications

(14 citation statements)

References 25 publications

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“… Determine the risk of therapy interruption of STR compared to BID or OD EFV therapy. Arroyo et al 2016 19 Spain Retrospective study 264 patients on ART treatment Evaluate the influence of the number of daily pills and daily doses on treatment adherence in a 7-year pharmaceutical care program. Velvanathan et al 2016 20 Malaysia Randomized control trial.…”

Section: Resultsmentioning

confidence: 99%

“… 6 , 15 , 18 , 20–22 One study did not assess the clinical outcomes associated with regimen simplification. 19 On the other hand, eight studies were identified that reported on the simplification of drug regimens related to other medical conditions. These included three that were conducted in the US, 13 , 14 , 24 two in Germany, 7 , 10 and one each in Hungary, Australia and South Korea.…”

Section: Resultsmentioning

confidence: 99%

“…No difference in adherence. Fabbiani et al 2014 18 Italy Single tablet regimen Treatment discontinuation Virological suppression Higher adherence and lower virological failure Arroyo et al 2016 19 Spain Reducing daily doses and pills Dispensing records No assessment Higher adherence levels. Velvanathan et al 2016 20 Malaysia Fixed-dose combination Morisky scores CD4 count Improved clinical outcomes and patients` adherence.…”

Section: Resultsmentioning

confidence: 99%

“… 6 Similar findings for adherence have also been reported by researchers in Spain. 19 Concerning oral diabetic and hypertensive medications, a combined simplification strategy was not associated with a noticeable impact on adherence. 7 However, the combined simplification intervention was associated with improvement in adherence with regards to injectable insulins.…”

Section: Discussionmentioning

confidence: 97%

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<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Elnaem¹,

Irwan²,

Abubakar³

et al. 2020

PPA

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Background This study aims to identify interventions used to reduce medication regimen complexity and to assess their impact on medication adherence and clinical outcomes. Methods A literature search was conducted using pre-defined search terms in three scientific databases, including ScienceDirect, ProQuest and MEDLINE. Original research articles published in English between 2009 and 2020 that assessed the impact of medication regimen simplification on medication adherence in patients with long-term medical conditions were eligible for inclusion. Review articles, meta-analysis studies and conference proceedings were excluded. Data charting was done in an iterative process using a study-specific extraction form. Results Of the 684 studies identified through initial searches, 17 studies were included in the review. Nine studies involved simplification of medication regimen related to HIV, while three studies focused on patients with diabetes with or without coronary artery disease. The remaining five studies included medications used among elderly patients or medications related to hypertension, psychiatric disorders, glaucoma and kidney diseases. Three medication regimen simplification strategies were identified; fixed-dose combination (n = 7), once-daily dosing (n = 4) and the combination of both fixed-dose and once-daily dosing (n = 6). Overall, most of the regimen simplification strategies (14 out of 17) were found to be useful in improving medication adherence. There was no assessment of clinical outcomes in four out of 17 studies. Furthermore, more than half of the studies that assessed clinical outcomes did not show any additional impact on clinical outcomes. Conclusion The findings suggest that there was an equal utilization of the three main approaches of regimen simplifications; fixed-dose combination, once-daily dosing and a combination of both. Overall, most of the regimen simplification strategies were found to be effective in improving medication adherence. However, the associated improvement in medication adherence did not extend to improvement in the clinical outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

See 2 more Smart Citations

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Elnaem¹,

Irwan²,

Abubakar³

et al. 2020

PPA

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“…Group, 2015) and INSIGHT START (Insight Start Study Group et al, 2015) studies. Further, modern regimens have fewer adverse effects (Margolis, Heverling, Pham, & Stolbach, 2014) and decreased pill burden and dosing frequency (Hernandez Arroyo et al, 2016). Globally consensus has been reached; since 2015 guidelines uniformly recommend immediate initiation of ART regardless of CD4 cell count (Lundgren, Gatell, Rockstroh, & Furrer, 2015;Thompson et al, 2012;WHO, 2015).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with delayed and late ART initiation among people living with HIV in BC: results from the engage study

et al. 2018

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We examined correlates of late and delayed initiation of antiretroviral therapy (ART) in British Columbia, Canada. From December 2013 to December 2015 we recruited treatment-naïve people living with HIV who initiated ART within the previous year. 'Late initiation' was defined as CD4 cell count ≤500 cells/µL at ART initiation and 'delayed initiation' as ≥1 year between HIV diagnosis and initiation. Multivariable logistic regression assessed independent correlates of late and delayed initiation. Of 87 participants, 44 (51%) initiated late and 22 (26%) delayed initiation. Delayed initiation was positively associated with older age (adjusted odds ratio [AOR]: 1.06 per year, 95% confidence interval [95% CI]: 1.01-1.12) and inversely associated with wanting to start ART at diagnosis (AOR: 0.06, 95% CI: 0.02-0.21). Variables associated with late initiation were older age (AOR: 1.09 per year, 95% CI: 1.03-1.15) and medical reason(s) for initiation (AOR: 5.00, 95% CI: 1.41-17.86). Late initiation was less likely among those with greater perceived ART efficacy (AOR 0.94, 95% CI: 0.90-0.98) and history of incarceration (AOR: 0.12, 95% CI: 0.03-0.56). Disparities in timing of initiation were observed for age, perceived ART efficacy, and history of incarceration. Enhanced health services that address these factors may facilitate earlier treatment initiation.

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Efficacy and tolerability of switching to a dual therapy with darunavir/ritonavir plus raltegravir in HIV-infected patients with HIV-1 RNA ≤50 cp/mL

et al. 2017

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raltegravir (RAL) while having a viral load (VL) ≤50 copies/mL in the clinical setting. Study design Treatment-experienced HIV 1-infected patients enrolled in the ICONA Foundation Study cohort were included if they switched their current regimen to DRV/r + RAL with a HIV-RNA ≤50 copies/mL. Different definitions of virological failure (VF) and treatment failure (TF) were employed. Kaplan-Meier curves and Cox regression models were performed to estimate time to event probability. Results We included 72 HIV-infected patients, 22 (31%) of these were female, 31 (43%) men who have sex with men (MSM) amd 15 (21%) had hepatitis co-infections. Median age was 44 (IQR: 35-50) years amd CD4 count was 389 (IQR 283-606) cells/mmc. Median follow-up time for TF was 24 (IQR 9-31) months. Twenty-five discontinuations occurred (60% simplifications); only 2 (8%) were toxicity-driven (lipid elevations). The probability of VF (confirmed VL >50 copies/mL) was estimated at 7% [95% confidence interval (CI) 1-13%] by 12 and 9% (95% CI 2-16%) by 24 months. When considering TF, we found a probability of stop/intensification/single VL > 200 copies/ mL of 13% (95% CI 1-17%) and 22% (95% CI 11-33%) by 12 and 24 months. Female gender (adjusted relative hazard, ARH = 0.10; 95% CI 0.01-0.74; p = 0.024) and older age (AHR = 0.50 per 10 years older; 95% CI 0.25-0.99; p = 0.045) were associated with a lower risk of TF. A previous PI failure was strongly associated with TF (AHR = 52.6, 95% CI 3.6-779; p = 0.004). Conclusions DRV/r + RAL is a valuable NRTI-sparing option, especially in female and older patients, with a relatively low risk of VF and good tolerability after 2 years since start in an ART-experienced population. However, previous PI-failure should be a limiting factor for this strategy. AbstractBackground Nucleos(t)ide reverse transcriptase inhibitors (NRTI) toxicity may represent a threat for long-term success of combined antiretroviral therapy. Some studies have suggested a possible improvement of NRTI-related toxicity after switching to NRTI-sparing regimens. Objectives We aimed to explore the efficacy and tolerability of switching to darunavir/ritonavir (DRV/r) plus

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Influence of the number of daily pills and doses on adherence to antiretroviral treatment: a 7-year study

Cited by 7 publications

References 25 publications

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Factors associated with delayed and late ART initiation among people living with HIV in BC: results from the engage study

Efficacy and tolerability of switching to a dual therapy with darunavir/ritonavir plus raltegravir in HIV-infected patients with HIV-1 RNA ≤50 cp/mL

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