Measurement of Adherence to Antiretroviral Medications

Paterson, David L.; Potoski, Brian A.; Capitano, Blair

doi:10.1097/00126334-200212153-00003

Cited by 115 publications

(100 citation statements)

References 17 publications

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“…49,50 Provision of a specified timeframe (the past 7 days) and including questions about specific behavior (eg, number of pills missed) are known to have improved self-report accuracy in this context. 51,52 As noted in the Methods section, validity of self-reports was cross-checked with electronic medication dispense records where available, which suggests accurate reporting. Long-term sustainability of the treatment effect beyond 12 months post randomization requires evaluation.…”

Section: -37mentioning

confidence: 99%

Improving Adherence to Secondary Stroke Prevention Strategies Through Motivational Interviewing

Barker‐Collo

Krishnamurthi

Witt

et al. 2015

Stroke

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S trokes recur in ≈25% of patients in the first year, 1-4 with a 5-year cumulative recurrent risk of 30% to 40%. 5 Recurrent stroke leads to greater disability and case fatality. 6,7 The stroke recurrence rate has not changed over the past 20 years. 4 Evidence-based secondary stroke prevention guidelines improve stroke outcomes and reduce costs, 8 but remain underutilized.9,10 Poor preventive care training, 11 discharge planning, 12,13 risk factor management, and communication with stroke patients/family 9 are likely contributors. 11,14Motivational interviewing (MI) aims to improve adherence to medication and lifestyle changes. MI facilitates intrinsic motivation to change behavior 15 and attempts to increase awareness of potential problems, consequences, and risks as a result of a behavior 16 and seeks to help people think differently about their behavior and consider potential gains through change. 17 MI is structured, patient-focused, 18-23 and more costeffective 24 than many other behavior change methods. 25,26 MI was developed for substance abuse management 21,22,27,28 but Background and Purpose-Stroke recurrence rates are high (20%-25%) and have not declined over past 3 decades. This study tested effectiveness of motivational interviewing (MI) for reducing stroke recurrence, measured by improving adherence to recommended medication and lifestyle changes compared with usual care. Methods-Single-blind, prospective phase III randomized controlled trial of 386 people with stroke assigned to either MI treatment (4 sessions at 28 days, 3, 6, and 9 months post stroke) or usual care; with outcomes assessed at 28 days, 3, 6, 9, and 12 months post stroke. Primary outcomes were change in systolic blood pressure and low-density lipoprotein cholesterol levels as indicators of adherence at 12 months. Secondary outcomes included self-reported adherence, new stroke, or coronary heart disease events (both fatal and nonfatal); quality of life (Short Form-36); and mood (Hospital Anxiety and Depression Scale). This trial aimed to determine the effectiveness of MI in improving adherence to medications (particularly blood pressure [BP] and cholesterol lowering medications) in stroke patients enrolled into a larger population-based stroke study. Changes in systolic BP and low-density lipoprotein (LDL) cholesterol levels were assessed as primary outcomes. Other lipid fractions (high-density lipoprotein cholesterol, total cholesterol, triglycerides, and glycohemoglobin), self-reported adherence, occurrence of new stroke/coronary heart disease (fatal/nonfatal), changes in quality of life, and mood were also assessed. Results-MI MethodsThree hundred eighty-six people aged ≥16 years with stroke (excluding subarachnoid hemorrhage) were enrolled. The methodology is described in detail elsewhere, 38 but briefly, potential participants were identified by a hospital-based research assistant through checking hospital databases and attendance at weekly team meetings for relevant wards/units. Eligible candidates were approached in...

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Section: -37mentioning

confidence: 99%

Improving Adherence to Secondary Stroke Prevention Strategies Through Motivational Interviewing

Barker‐Collo

Krishnamurthi

Witt

et al. 2015

Stroke

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“…Other measures of adherence, such as electronic drug monitoring or pill counts would provide additional supportive data. Although self-report measures are useful for assessing non-adherence [1,26] , many participants, particularly current substance users, tend to overestimate their adherence level with self-report measures [1,35] or may not consider themselves nonadherent when they modify their own regimen [36] .Overestimation as a consequence of current substance use may also explain the high levels of selfefficacy endorsed by current users at baseline, comparable to the alcoholic's estimation of their driving skills while "under the influence".…”

Section: Discussionmentioning

confidence: 99%

“…Adherence to HIV treatment regimens is critical to optimal disease management, yet rates of adherence to antiretroviral (ARV) medications are frequently less than ideal and negatively affect long-term goals for disease management, including drug resistance, poor health outcomes and treatment failure [1,2] .…”

Section: Introductionmentioning

confidence: 99%

HIV Medication Adherence and Substance Use: The Smartest Womenâ€™s Project

Lopez¹,

Rodriguez²,

Ishii³

et al. 2007

American J. of Infectious Diseases

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Antiretroviral (ARV) medication for substance users has been a controversial issue with respect to whether current substance users can successfully maintain their medication regimens. This study compared ARV adherence across current substance users, former substance users and those with no history or current use and the relative impact of a medication adherence intervention on all three groups. Of the 481 predominantly African American and Latina women from Miami, New York and New Jersey enrolled in the SMARTEST Women's Program, 338 participants were prescribed antiretroviral medication at study entry. All three groups, current users (n=60), former users (n=107) and never users (n=171), reported relatively high levels of adherence at baseline. Of those participants with less than 80% adherence at baseline, former users showed the most significant decrease in viral load post-intervention and at long term (two year) follow-up. These findings suggest former users to be the most reliable source of self-reported adherence and to profit most from the study intervention. They also suggest that additional research on targeted interventions for current substance users may be necessary to improve medication adherence for this group of women living with HIV.

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“…Successful long-term treatment of HIV/AIDS requires at least 95% adherence to the antiretroviral therapy (HAART) required for viral suppression required to keep people living with HIV/AIDS (PLHIV) in good health and prevent emergence of drug-resistant HIV variants that could lead to regimen failure and limit options for future therapy [14][15][16]. Despite all the strategies to address the adherence barriers to prescribed HAART drug regimens to manage HIV/AIDS, the problems of inadequate observance are ever-present [17].…”

Section: Highly Active Antiretroviral Therapy (Haart)mentioning

confidence: 99%

Explaining Adherence to HAART among Patients Living with HIV/AIDS in Nigeria: Behavioral Theory Analysis

Afe¹,

Motunrayo²,

Ogungbade³

2017

J AIDS Clin Res

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Background: The number of Nigerians infected with the HIV infection in 2016 was about 3 million, which was the second highest burden globally and accounted for 9% of the worldwide burden of the HIV/AIDS. The country ART (antiretroviral therapy) programme which commenced in 2001 had adult coverage of 48.3% in 2014. Effectiveness of the antiretroviral drug regimens requires a very good level of adherence (95%) to suppress viral replication. Despite all the strategies to address the adherence barriers to HAART (highly active antiretroviral therapy), the problems of poor adherence are ever-present. Factors determining adherence to HAART drug regimens have been studied in various population but little is known on this subject among PLHIV (people living with HIV) in Nigeria. Identifying and overcoming the factors that reduce adherence to combination antiretroviral agents is of utmost importance for prolonged viral load suppression.Very few of the strategies developed to mitigate the challenges of non-adherence were based on the theories of health behavior. However, behavioural theories, if adopted, could assist in the development of more effective interventions to improve treatment adherence. This cross-sectional study was conducted to explain the dynamics of HAART adherence among Nigerians living with HIV/AIDS; using behaviour change theories such as the Theory of Planned Behavior (TPB) and Health Belief Model (HBM). Methods:This was a questionnaire-based study using closed ended-questionnaires administered by the on the 225 participants.Findings: There were more female (181, 80.40%) than male (19.6%) living with HIV infection among the respondents. More than half, (139, 61.7%), of the respondents were married while less than a fifth (66; 29%) were singles About 96% of the respondents were literate with 2.7% illiteracy rate. Employment rate was also more than half (59%) while the unemployed rate was about 31.6%. Most (202, 89.8%) were of the Christianity faith TPB model factors such as the ability to set realistic goals and objectives with respect to medication adherence and meet such goals did not have any significant association with adherence (P 0.001) among the PLHIV. Likewise other TPB factors like determination and self-discipline to adhere to medications (HAART) did not have statistical association with HAART adherence. On the other hand, Health Believe Model (HBM) components such as the believes that adherence to HAART improves HIV patent's health condition (P=0.004),adherence to HIV medication is feasible in the Nigerian context (P=0.00), refusal to adhere to HAART is a serious health risk for the HIV patient (P=0.00), non-adherence to HAART is life threatening for the HIV patient(P=0.00), non-adherence to HAART can lead to AIDS faster (P=0.00) and the consequences of non-adherence to HAART are severe (P=0.00) all show significant statistical association with HAART adherence .Also significant statistical association was found between HAART adherence and other health believes like adherence to HAART i...

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Measurement of Adherence to Antiretroviral Medications

Cited by 115 publications

References 17 publications

Improving Adherence to Secondary Stroke Prevention Strategies Through Motivational Interviewing

Improving Adherence to Secondary Stroke Prevention Strategies Through Motivational Interviewing

HIV Medication Adherence and Substance Use: The Smartest Womenâ€™s Project

Explaining Adherence to HAART among Patients Living with HIV/AIDS in Nigeria: Behavioral Theory Analysis

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