Mild-to-Moderate Symptoms during the First Year of Antiretroviral Therapy Worsen Quality of Life in HIV-Infected Individuals

Mannheimer, Sharon; Wold, Nicholas; Gardner, Edward M.; Telzak, Edward E.; Hullsiek, Katherine Huppler; Chesney, Margaret A.; Wu, Albert W.; MacArthur, Rodger D.; Matts, John P.; Friedland, Gerald

doi:10.1086/528859

Cited by 21 publications

(25 citation statements)

References 30 publications

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“…In addition, for each avoided bothersome symptom, there was an associated increase by almost one point in HRQoL (b estimate -0.94, 95% CI -1.03, -0.86), consistent with the recognized impact of symptoms on HRQoL. [4][5][6][7][8][9] Of note, a three to five point increase in this score represents a clinically important difference, 49 highlighting the importance of symptom management to improve HRQoL. In our analyses, disease severity based on five point increases in the VACS Index 33,45 was also associated with HRQoL (b estimate -0.51, 95% CI -0.62, -0.41) as was serious mental illness (b estimate -1.37, 95% CI -2.48, -0.27).…”

Section: Edelman Et Alsupporting

confidence: 56%

“…1,7,10,[39][40][41] This pattern, however, may reflect a shifting balance in symptom etiology as associated treatment toxicities decrease and comorbidities increase. [42][43][44][45] For example, diarrhea/loose bowels was reported half as commonly in our current population as in a similar group from an earlier treatment era, 10 perhaps reflecting a shift away from use of older antiretroviral agents, such as nelfinavir, 1,46,47 higher to lower dose ritonavir, and possibly better symptomatic management of side effects.…”

Section: Discussionmentioning

confidence: 99%

“…Independent of their cause, symptoms may impact adherence. [1][2][3] Moreover, symptoms are major contributors to important clinical outcomes, including quality of life, [4][5][6][7][8][9][10][11] hospitalization, and mortality. 10 Despite an array of available treatment options, HIV therapy has converged on the non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (EFV) and the nucleoside reverse transcriptase inhibitor backbone (NRTI) including emtricitabine (FTC) and tenofovir (TDF).…”

Section: Introductionmentioning

confidence: 99%

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Patient-Reported Symptoms on the Antiretroviral Regimen Efavirenz/Emtricitabine/Tenofovir

Edelman

Gordon²,

Rodriguez‐Barradas³

2012

AIDS Patient Care and STDs

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Most patients (80-90%) newly diagnosed with HIV are started on the antiretroviral regimen efavirenz, emtricitabine, and tenofovir (EFV/FTC/TDF). Existing studies of patient tolerability, however, are limited. We compared symptom experiences of patients on EFV/FTC/TDF, and the subsequent impact on health-related quality of life, with those of patients on other combination antiretroviral therapy (cART). We conducted a cross-sectional analysis of the Veterans Aging Cohort Study from February 2008 to August 2009 to compare the symptom experiences of patients on EFV/FTC/TDF vs. other cART, unadjusted and then adjusted for treatment characteristics, and comorbid disease severity. We then assessed the association between EFV/FTC/TDF use and health-related quality of life. Among the 1,759 patients in our analytic sample, EFV/FTC/TDF use was associated with fewer symptoms than was other cART. The use of EFV/FTC/TDF was independently associated with health-related quality of life, and this association was at least partially explained by symptom burden.

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Section: Edelman Et Alsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient-Reported Symptoms on the Antiretroviral Regimen Efavirenz/Emtricitabine/Tenofovir

Edelman

Gordon²,

Rodriguez‐Barradas³

2012

AIDS Patient Care and STDs

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“…9 Whereas some infected individuals will contact their healthcare provider (HCP) about various symptoms, others will seek to remediate the conditions through a process of self-care management using the advice of family members, friends, and other HIVinfected individuals. Those individuals who have reported their symptoms to their provider may also engage in self-care management, particularly if the symptoms persist.…”

Section: Management Of Symptoms and Side Effectsmentioning

confidence: 99%

Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection

Corless

Wantland

Kirksey

et al. 2012

AIDS Patient Care and STDs

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General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n=569) of an international 12 site longitudinal randomized controlled trial (RCT) (n=775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly (p= < 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted.

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“…Several studies have reported that nausea is the most frequently reported adverse reaction to medication therapy (Guimaraes et al, 2008). In addition, adverse reactions have been linked to nonadherence and consequent suboptimal health-related outcomes in patients with HIV (Golub Indyk, & Weinburg, 2006;Mannheimer et al, 2008;Murphy, Sarr, Durako, Moscicki, & Wilson, 2003) as well as increased risk of transmitting the disease (Holstad et al, 2006).…”

mentioning

confidence: 99%

Experiences of Nausea in Persons With HIV/AIDS

Anderson

Delaney²,

Hull³

2010

Journal For Nurses in Staff Development (JNSD)

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The aim of this phenomenological study was to explore and describe patients with HIV/AIDS experiences with nausea as it affects their abilities to take medications, to eat, and to engage in life activities. Forty-five men and 21 women with a mean age of 42.33 years (SD = 8.44 years) participated in the study. Data were analyzed using Colaizzi's phenomenological method. Five themes emerged: (a) daily anticipation, (b) sensory invasion, (c) emotional medley, (d) stigma and secrecy, and (e) searching for solutions. Recommendations for staff development educators on the basis of partnerships with academia are presented.

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Mild-to-Moderate Symptoms during the First Year of Antiretroviral Therapy Worsen Quality of Life in HIV-Infected Individuals

Cited by 21 publications

References 30 publications

Patient-Reported Symptoms on the Antiretroviral Regimen Efavirenz/Emtricitabine/Tenofovir

Patient-Reported Symptoms on the Antiretroviral Regimen Efavirenz/Emtricitabine/Tenofovir

Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection

Experiences of Nausea in Persons With HIV/AIDS

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