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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Readiness, trust, and adherence: a clinical perspective.

Richard M Grimes¹, Deanna E Grimes

¹Department of Medicine, The University of Texas Health Science Center, Houston, TX, USA. richard.m.grimes@uth.tmc.edu

Journal of the International Association of Providers of AIDS Care

|August 21, 2012

Summary

Current HIV treatment guidelines lack scientific support for readiness and trust recommendations. More research is needed on effective, replicable adherence interventions for long-term antiretroviral therapy.

Keywords:

HIV/AIDS adherence readiness trust

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Published on: February 16, 2011

Area of Science:

Medical Science
Public Health
Behavioral Science

Background:

HIV treatment guidelines often include recommendations on patient readiness and trust.
The scientific evidence supporting these recommendations requires thorough examination.

Purpose of the Study:

To evaluate the scientific basis for readiness, trust, and adherence recommendations in HIV treatment guidelines.
To assess the quality of evidence regarding definitions, measures, and interventions for readiness, trust, and adherence.

Main Methods:

Systematic review of 5 HIV treatment guidelines from expert panels.
Analysis of 5 review articles on readiness, trust, and adherence to assess evidence quality.
Evaluation for concept definitions, outcome-predictive measures, and replicable interventions.

Main Results:

No robust definitions or predictive measures for readiness or trust were found.
Evidence for interventions improving readiness or trust in a clinically meaningful way is lacking.
Adherence is defined as taking medications as prescribed, but measures show poor correlation, and interventions are poorly described and difficult to replicate.

Conclusions:

Further research on readiness and trust is unlikely to yield significant clinical benefits.
Systematic, long-term research on clinician-based adherence interventions is crucial.
Longitudinal cohort studies are necessary to understand lifelong adherence to antiretroviral treatment.