Background
Antiretroviral efficacy is closely related to the degree of adherence
Purpose
To determine the adherence to highly active antiretroviral therapy (HAART) in HIV-infected patients with once-daily dosing regimens, depending on the number of tablets.
Materials and MethodsTwo-month observational study (May–June 2010 of selected patients on HAART who collected their medicines in the pharmacy with the following inclusion criteria: adult patients on HAART for more than a year, who were not included in any clinical trials, mentally competent and who obtained the medicines exclusively in our LEU.
The SMAQ survey was used to assess adherence. Adherence data, along with the number of tablets and demographic characteristics of the patients were tabulated and analysed using Excel.
Results
223 patients were included in the study. 39.5% (n = 88) had once-daily regimens. 72 were men and 16 women. The mean age was 44.3 years and 7.35 years on HAART. The mean adherence was 67.05%.
The study population was divided into two groups: one tablet (OT) (n = 49) and two or more tablets (MT) (n = 39). Baseline characteristics were homogeneous in the two groups. However adherence rates were 71.42% vs. 61.54% respectively (p = 0.3268).
Conclusions
Simple dosing regimens facilitate adherence to HAART. In our study we found that OT patients were more adherent that MT patients. Although the difference in adherence was not statistically significant, we believe that this difference may have high clinical impact on controlling the disease.
No conflict of interest.
I501, I509, I110, I130 and I132. For each hospitalization, a weighted disease related group (DRG) cost (€ , 2012) was calculated. No discount rate was applied. Results: If 100,000 patients are treated with sacubitril/valsartan, about 4,500 deaths and 39,000 hospitalizations may be avoided over 5 years. From a DRG perspective those avoided hospitalizations may lead to cost savings of about 130m€ . From a hospital budget perspective this may lead to a 10m€ avoided budget deficit. Indeed, there was a difference between weighted DRG cost (3,329€ ) and costs incurred in the national cost study (Etude Nationale de Coûts à méthodologie Commune) for HF hospitalizations (3,591€ ). The budget deficit corresponds to this difference multiplied by the number of avoided hospitalizations. ConClusions: From the French hospital perspective, sacubitril/valsartan introduction in HF treatment strategy has the potential to generate substantial savings and to minimize budget deficit. An analysis from a broader perspective (including drugs costs) should be conducted.
Conclusion and relevance It seems that adjusted doses of anthracyclines in obese paediatric patients can be effective and safety but due to limited data, this recommendation must be taken with caution. REFERENCES AND/OR ACKNOWLEDGEMENTS No conflict of interest.
In total, 13.46% (n=7) of patients stopped treatment with omalizumab: 3 patients receiving a dose of 150 mg for improvement in disease, 3 for inefficiency and in 1 the reason was unknown. Adverse reactions occurred in 2 patients: 1 patient had alopecia and asthenia and another patient gained weight. Conclusion and relevance There was a high percentage of patients in our centre who received a dose of omalizumab 300 mg monthly for CIU but a reduced dose (150 mg monthly) was equally effective and safe, even stopping treatment for improvement in CIU which would also have an economic impact.
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