Utility of the Millon Behavioral Medicine Diagnostic (MBMD) to Predict Adherence to Highly Active Antiretroviral Therapy (HAART) Medication Regimens Among HIV-Positive Men and Women

Abstract

Psychosocial and behavioral factors may be strong predictors of adherence to medications in a wide variety of diseases. Newly emerging antiretroviral medications for HIV have been shown to be effective but require near perfect adherence to offer clinically significant benefits. There is currently great interest in deriving patient factors that may predict optimal medication adherence in HIV-positive persons. In this study, we examined the association of psychosocial and behavioral characteristics using the Millon Behavioral Medicine Diagnostic (MBMD; Millon, Antoni, Millon, Meagher, & Grossman, 2001) and adherence to highly active antiretroviral therapy (HAART) among 117 HIV-positive individuals on HAART regimens. Specific indexes of the MBMD were associated with HAART adherence as assessed through patient interview, at baseline assessment, and at 3-month follow-up at a point after which participants had received medication adherence training. As hypothesized, the Medication Abuse scale of the MBMD was uniquely associated with overall adherence at baseline assessment and also predictive of adherence at 3-month follow-up. Additional MBMD scales were also related to overall adherence as well as specific adherence behaviors such as missed doses, following specific instructions, and overmedicating, although the Medication Abuse scale emerged as the most consistent predictor of adherence in the study. These results suggest that the MBMD can be used to predict adherence to HAART medication in a sample of HIV-positive men and women and may subsequently be used to identify those in need of adherence counseling at the point when medications are initiated.

Patient Attitudinal and Behavioral Factors Associated with Warfarin Non-adherence at Outpatient Anticoagulation Clinics

“…The MBMD was developed specifically for medical patient populations and provides a broad assessment of patient adjustment to medical illness. The MBMD has been used effectively to explain medication adherence among HIV-positive men and women undergoing highly active antiretroviral therapy (HAART) over a 3-month period [23]. The current study, however, is the first to examine the MBMD in relation to warfarin adherence.…”

Predictive Utility of Brief Alcohol Use Disorders Identification Test (AUDIT) for Human Immunodeficiency Virus Antiretroviral Medication Nonadherence

“…At the same time, alcohol use must be considered in light of the numerous other individual factors long associated with ART adherence to varying degrees, for example, self-efficacy for medication adherence (15,16); depressive symptoms (15,17); social support (15,16); and personality characteristics (18). The aim of this study was to determine if positive screening results on the AUDIT-C and/or AUDIT-3 provide additional prediction of ART adherence based on electronic event monitoring (EEM), after controlling for selected sociodemographic and psychosocial variables commonly associated with ART adherence and possibly with positive AUDIT-C and/or AUDIT-3 status.…”

Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy?

“…13 Several psychological questionnaires, including the Millon Behavioral Medicine Diagnostic (MBMD) survey, have been used successfully to predict responses to medical treatments, including surgery in patients with congestive heart failure, morbid obesity (bariatric surgery), cancer, human immune virus (human immunodeficiency virus), and facial pain. [14][15][16][17][18] The MBMD survey is available as a norm-referenced and pain-referenced instrument consisting of 165 true-or-false questions that yield 5 broad categories of clinical scales: psychiatric diagnoses, coping styles, stress moderators, treatment prognostics, and management guides. Within these 5 categories are 29 additional scales.…”