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Factors affecting adherence to antiretroviral therapy
1School of Medicine, University of California San Francisco, San Francisco, CA 94105, USA. mchesney@psg.ucsf.edu.
Summary
Medication nonadherence is common in chronic diseases, especially with human immunodeficiency virus (HIV) combination therapies. Addressing patient-specific factors and simplifying treatment regimens are key to improving adherence.
Area of Science:
- Medical Science
- Public Health
- Infectious Diseases
Background:
- Nonadherence to medications is prevalent in chronic disease management.
- The adoption of combination therapies for human immunodeficiency virus (HIV) has intensified adherence challenges.
- Antiretroviral therapy nonadherence rates range from 50% to 70%, impacting treatment efficacy.
Purpose of the Study:
- To explore the widespread issue of medication nonadherence in chronic diseases.
- To identify the primary factors contributing to nonadherence in patients with HIV.
- To discuss strategies for improving medication adherence in HIV-infected individuals.
Main Methods:
- Review of clinical trials and clinical practice data on medication adherence.
- Analysis of patient-reported reasons for nonadherence in HIV treatment.
- Discussion of contributing factors including patient-related issues, regimen complexity, and healthcare system elements.
Main Results:
- Nonadherence rates for antiretroviral therapy (ART) are estimated between 50% and 70%.
- Adherence below 80% is linked to detectable viremia in most patients.
- Patient-related factors, such as substance abuse, are principal contributors to nonadherence.
Conclusions:
- Improving adherence requires clear communication of treatment regimens.
- Tailoring treatment plans to individual patient lifestyles is crucial for better outcomes.
- Addressing factors like dosing frequency, side effects, and patient-provider relationships can enhance adherence.