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Prospective State and Trait Predictors of Daily Medication Adherence Behavior in HIV.
Paul F Cook1, Sarah J Schmiege, Whitney Starr
1Paul F. Cook, PhD, is Associate Professor; and Sarah J. Schmiege, PhD, is Associate Professor, University of Colorado College of Nursing, Aurora. Whitney Starr, MSN, NP, is Instructor, University of Colorado School of Medicine, Aurora. Jane M. Carrington, PhD, RN, is Assistant Professor, University of Arizona College of Nursing, Tucson. Lucy Bradley-Springer, PhD, FAAN, ACRN, is Associate Professor Emeritus, University of Colorado School of Medicine, Aurora.
Daily mood and motivation, not long-term traits, predict medication adherence in people living with HIV (PLWH). Interventions targeting daily psychological states may improve adherence to antiretroviral therapy.
Area of Science:
- Behavioral Science
- Health Psychology
- Infectious Disease Management
Background:
- Medication nonadherence is a significant challenge for persons living with HIV (PLWH).
- Trait-level adherence predictors may not capture daily fluctuations impacting adherence.
- Understanding daily variability is crucial for improving treatment outcomes.
Purpose of the Study:
- To evaluate six predictors of medication adherence at both state and trait levels in PLWH.
- To compare the relative predictive effects of state versus trait variables on adherence.
- To investigate the impact of daily thoughts, mood, stress, coping, social support, and motivation on adherence.
Main Methods:
- A smartphone-based daily survey assessed state variables in 87 PLWH.
- Baseline surveys measured trait-level constructs for all participants.
- Multilevel models analyzed next-day adherence predicted by state and trait variables in 53 PLWH using electronically monitored medication bottle openings.
Main Results:
- Higher daily motivation and negative mood predicted greater next-day adherence (state-level effects).
- Trait-level control beliefs predicted adherence, but trait mood, stress, coping, social support, and motivation did not.
- State-level effects were significant, while some trait-level measures did not predict adherence as hypothesized.
Conclusions:
- Both state and trait measures predict adherence, but with important differences.
- Daily variations in motivation and negative mood are key predictors of adherence.
- Future interventions should consider targeting state-level psychological variables to enhance medication adherence in PLWH.
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