Patterns and Correlates of Discontinuation of the Initial HAART Regimen in an Urban Outpatient Cohort

Abstract

Gastrointestinal adverse events of HAART are the most frequently cited reason for discontinuation of HAART. An effort should be made to educate patients about these events and to encourage continued adherence. Additionally, appropriate prophylaxes for these events are warranted.

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

“…1,7,[9][10][11][12][13][14] The most frequently reported side effects are gastrointestinal, including nausea, vomiting, and diarrhea. The ICONA study demonstrated that 25% of participants discontinued a HAART regimen by 1 year due to toxicity.…”

“…Concern regarding drug toxicity affects not only adherence to HAART regimens in patients being treated, but also may prevent some patients from initiating treatment. Bassetti and colleagues found that among their patients re- [1][2][3][4][5][6][7][8][9][10][11][12] fusing treatment with HAART, 19% feared side effects and 18% thought that the treatment regimen was overly complicated. 9 Improving patient education regarding the benefits of viral suppression and potential drug side effects and suggesting methods to help adhere to antiretroviral regimens are potential means of increasing initiation and decreasing discontinuation rates.…”

“…[1][2][3][4][5][6] However, toxicity associated with many of the antiretroviral drugs often leads to discontinuation or changes in treatment and also limits patient adherence and, therefore, virologic effectiveness. [7][8][9] Several observational studies have shown that medication side effects are the most common cause of discontinuation of HAART regimens.…”

“…[7][8][9] Several observational studies have shown that medication side effects are the most common cause of discontinuation of HAART regimens. 1,7,[9][10][11][12][13][14] Gastrointestinal (GI)-related side effects such as nausea, vomiting, and diarrhea have been among the most commonly reported medication toxicities leading to regimen discontinuation in numerous studies. 1,7,12,13,15,16 Other studies have shown that certain patient characteristics such as race, gender, or socioeconomic status may predict higher rates of regimen discontinuation.…”

The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study

“…Symptoms are common among individuals receiving HAART (Bonfanti et al, 2000;Lucas et al, 1999) and have been associated with both non-adherence (Ammassari et al, 2001;Chesney et al, 2000) and discontinuation of HAART (Mocroft et al, 2001;O'Brien et al, 2003). In order to develop appropriate interventions, several methodological issues need to be addressed.…”