An adherence trilogy is essential for long-term HAART success

Garcia, Rosa; Schooley, Robert T.; Badaró, Roberto

doi:10.1590/s1413-86702003000500005

Cited by 27 publications

(29 citation statements)

References 37 publications

(42 reference statements)

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“…A good response to ARV treatment is a condition that encourages patients to seek medical care and to adhere to the treatment. 4. Therapeutic relationship.…”

Section: Discussionmentioning

confidence: 99%

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The importance of the doctor-patient relationship in adherence to HIV/AIDS treatment: a case report

Garcia¹,

Lima²,

Gorender³

et al. 2005

Braz J Infect Dis

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In this case report, which includes a statement related by the patient himself, the authors also discuss the importance of a good doctor-patient relationship in treating HIV patients and in assuring the patient's adherence to his treatment. Related issues, such as the importance of treating psychiatric comorbidities, of preserving the patient's hope and motivation, and of giving him an adequate amount of information regarding the disease and its treatment, are also discussed.

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“…A good response to ARV treatment is a condition that encourages patients to seek medical care and to adhere to the treatment. 4. Therapeutic relationship.…”

Section: Discussionmentioning

confidence: 99%

“…To insure adherence, a trilogy composed of information, motivation and behavioral skills is essential in HAART [4].…”

mentioning

confidence: 99%

The importance of the doctor-patient relationship in adherence to HIV/AIDS treatment: a case report

Garcia¹,

Lima²,

Gorender³

et al. 2005

Braz J Infect Dis

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“…However, it has been demonstrated that patients on HAART must take at least 95% of their medication doses consistently to lower their viral load count to less than 50 and to avoid developing drug resistance, [1][2][3] causing medication regimen adherence to be extremely difficult. Adherence to medication has been defined as having in place Division of Adolescent Medicine, Childrens Hospital Los Angeles, Los Angeles, California.…”

Section: Introductionmentioning

confidence: 99%

“…1 These conditions for success have been grouped into four categories: regimen characteristics, patient specific factors, provider-patient relationship, and overall health care systems. 2 Common barriers to HAART adherence have been described as complex dosing, debilitating side effects, depression, unstable housing, and limited social support.…”

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confidence: 99%

The Use of Cell Phone Reminder Calls for Assisting HIV-Infected Adolescents and Young Adults to Adhere to Highly Active Antiretroviral Therapy: A Pilot Study

Puccio

Belzer

Olson

et al. 2006

AIDS Patient Care and STDs

142

139

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Long-term medication regimen adherence is challenging in all populations, but in the HIVinfected adolescent population the frequency of poverty, homelessness, substance abuse, and mental illness make highly active antiretroviral therapy (HAART) adherence even more challenging. In 2003, we developed a pilot program for HIV-infected adolescents and young adults between the ages of 16 and 24 who were either going to begin a HAART regimen for the first time or begin a new HAART regimen. Participants received a free cell phone with a local service plan for approximately 6 months. Participants received phone call reminders for 12 weeks. Call frequency was tapered at 4-week intervals. Patients were assessed at 4-week intervals to determine the perceived intrusiveness or helpfulness of receiving calls, and missed medication doses. Eight consecutive patients were recruited for the study, and five were able to complete it through the 24 weeks. Most participants found the calls to be helpful and the level of intrusion into their daily lives acceptable. Using cell phone reminders to assist patients does not require an extensive amount of daily staff time. Tapering calls rapidly over 3 months, followed by discontinuation of calls provided inadequate support for subjects, especially those with significant psychosocial issues such as substance abuse. Use of cell phone reminders to assist adolescents adhere with HIV medications was practical and acceptable to pilot study participants. Viral suppression waned for all but two patients after termination of cell phone reminders and suggests that a 12-week intervention was not adequate for most subjects. Larger prospective studies of cell phone observation of therapy will be needed to determine if this intervention can improve long-term adherence and health outcomes.

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“…Actual adherence to treatment in most chronic diseases varies between 33% and 80%; 10,11 however, the unique characteristics of HIV necessitate near-perfect adherence to antiretroviral therapy (ART). [12][13][14][15][16][17][18] Reportedly, ART adherence rates of 90 -100% are required to: ensure suppression of viral replication; 12,19,[20][21][22] maintain CD4 cell counts; prevent clinical progression to AIDS; and prevent the development of ART drug resistance and resistant HIV strains, 10,[23][24][25][26][27][28] which could leave drug-naive patients with few effective treatment options.…”

mentioning

confidence: 99%