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Long-term Medication Adherence in Patients Receiving Antiretroviral Drug Therapy
Lee Preininger1, Kelly Cantwell-McNelis, Christopher James
1HIV Program, Christiana Care Health System, Wilmington, DE 19899, USA.
Objective:
A long-term medication adherence project was designed and implemented in an urban HIV clinic to address antiretroviral medication adherence.
Design And Methods:
We conducted a prospective study of patients on long-term antiretroviral therapy. Referred patients were on antiretroviral agents at least six months and had two consecutive detectable viral loads. A standarized form was utilized to assess medication adherence, including patient report, practitioner assessed barriers, and pharmacy refill history. Individualized interventions were developed to accommodate patient needs.
Results:
Seventy-eight patients met inclusion criteria for a total of 81 cases per study protocol. The majority of cases had an identifiable cause related to missed and/or mistimed doses. Following adherence interventions, 51 of the 81 cases (63%) experienced a successful outcome. In addition, 16 of the 27 cases (59%) without an identifiable cause became undetectable following intervention.
Conclusions:
This novel approach demonstrates that a proactive method for addressing barriers to long-term medication adherence yields improved patient understanding and preservation of treatment regimens.
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