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Randomized trial of an adherence programme for clients with HIV
C K Fairley1, R Levy, C R Rayner
1Department of Public Health, University of Melbourne, and Melbourne Sexual Health Centre, Melbourne, Australia. cfairley@unimelb.edu.au
International Journal of STD & AIDS
|December 18, 2003
Summary
A comprehensive adherence package significantly improved self-reported adherence to antiretroviral therapy in the short term. This intervention showed reduced missed doses in the last 4 and 7 days, but not over 28 days.
Area of Science:
- Public Health
- Infectious Diseases
- Clinical Pharmacy
Background:
- Adherence to antiretroviral therapy (ART) is crucial for managing HIV/AIDS.
- Suboptimal adherence can lead to treatment failure and drug resistance.
- Comprehensive adherence interventions may enhance patient compliance.
Purpose of the Study:
- To evaluate the effectiveness of a multifaceted adherence package on self-reported adherence to ART.
- To assess the impact of the intervention on viral load and CD4 lymphocyte counts.
Main Methods:
- A randomized step wedge design involving 43 participants was employed.
- The adherence package included education, individualized regimen planning, and choice of adherence aids.
- Self-reported adherence was measured using the Morisky score and missed doses over different timeframes.
Main Results:
- A significant reduction in missed ART doses was observed for the last 4 days (P=0.03) and 7 days (P=0.005).
- No significant changes were found in viral load or CD4 lymphocyte counts post-intervention.
- The Morisky score showed a significant difference between pre- and post-intervention periods (P=0.006).
Conclusions:
- The comprehensive adherence package effectively improved short-term self-reported adherence to antiretroviral therapy.
- While short-term adherence improved, long-term adherence and clinical outcomes like viral load require further investigation.
- Patient-centered adherence strategies are vital for optimizing HIV treatment outcomes.