A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India

George, Christophe; Yesoda, Anitha; Jayakumar, B.; Lal, Luxshimi

doi:10.1111/j.1365-2710.2008.00988.x

Cited by 11 publications

(16 citation statements)

References 32 publications

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“…There were seven cross-sectional studies(11122122232425) and one retrospective chart analyses. (26) Three studies were conducted in southern India(212426) and two each in western(1225) and north India. (2223) One study enrolled participants from western and northern India.…”

Section: Resultsmentioning

confidence: 99%

“…Seventy-five percent (6/8) of the studies reported the recall period. (112122242526) The length of recall period varied from previous 4 days to lifetime recall [Table 2]. …”

Section: Resultsmentioning

confidence: 99%

“…Thirty-seven percent (3/8) of the studies(122324) did not report the definition of treatment adherence. Sixty-two percent of studies (5/8) defined ART adherence.…”

Section: Resultsmentioning

confidence: 99%

“…However, 99% (7/8) of the studies used the self-reporting method for assessment of treatment adherence, while only one study used the pill count method. (24) The study by George et al . (24) used the pill count method and followed three groups of patients for 6 months.…”

Section: Resultsmentioning

confidence: 99%

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Adherence to antiretroviral therapy in India: A systematic review and meta-analysis

Mhaskar

Alandikar

Emmanuel

et al. 2013

Indian J Community Med

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Objective:To assess the adherence to antiretroviral therapy (ART) in the human immunodeficiency virus (HIV)-infected population in India.Design:Systematic review and meta-analysis.Materials and Methods:The Medline and Cochrane library database were searched. Any prospective or retrospective study enrolling a minimum of 10 subjects with a primary objective of assessing ART adherence in the HIV population in India was included. Data were extracted on adherence definition, adherence estimates, study design, study population characteristics, recall period and assessment method. For metaanalysis, the pooled proportion was calculated as a back-transform of the weighted mean of the transformed proportions (calculated according to the Freeman-Tukey variant of the arcsine square root) using the random effects model.Results:There were seven cross-sectional studies and one retrospective study enrolling 1666 participants. Publication bias was significant (P = 0.003). Pooled results showed an ART adherence rate of 70% (95% confidence interval: 59–81%, I2 = 96.3%). Sensitivity analyses based on study design, adherence assessment method and study region did not influence adherence estimates. Fifty percent (4/8) of the studies reported cost of medication as the most common obstacle for ART adherence. Twenty-five percent (2/8) reported lack of access to medication as the reason for non-adherence and 12% (1/8) cited adverse events as the most prevalent reason for non-adherence. The overall methodological quality of the included studies was poor.Conclusion:Pooled results show that overall ART adherence in India is below the required levels to have an optimal treatment effect. The quality of studies is poor and cannot be used to guide policies to improve ART adherence.

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Section: Resultsmentioning

confidence: 99%

“…Seventy-five percent (6/8) of the studies reported the recall period. (112122242526) The length of recall period varied from previous 4 days to lifetime recall [Table 2]. …”

Section: Resultsmentioning

confidence: 99%

“…Thirty-seven percent (3/8) of the studies(122324) did not report the definition of treatment adherence. Sixty-two percent of studies (5/8) defined ART adherence.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Adherence to antiretroviral therapy in India: A systematic review and meta-analysis

Mhaskar

Alandikar

Emmanuel

et al. 2013

Indian J Community Med

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“…Institutional factors are also important to emphasize, since free access to HAART and uninterrupted supply have proven to be crucial to achieve and maintain good levels of adherence in resource-constrained settings. 6,16,17 In a 12-month study conducted to evaluate the impact of a similar intervention on a comparable group of 96 patients at the University Hospital of Casablanca, Marchand et al found a baseline adherence score of 0.7, which improved at M3, amounting to 0.87, and to 0.91 at M12. 18 In another resource-limited setting at Jos University Hospital in Nigeria, Abah et al examined the impact of a program to support adherence among 121 patients recently enrolled in the HarvardPepfar HAART initiative and showed that the proportion of patients who had an adherence level superior to 95% increased from 79.4% of the cohort at the beginning of the study, to 92.4% at the end.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Psychoeducative Intervention on Adherence to HAART among Low-Literacy Patients in a Resource-Limited Setting: The Case of an Arab Country—Morocco

Khachani

Harmouche

Ammouri

et al. 2011

Journal of the International Association of Physicians in AIDS

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Research has demonstrated that strict adherence is necessary to maximize highly active antiretroviral therapy (HAART) benefits. This is particularly challenging for low-literacy populations in resource-limited settings like Morocco and motivated the implementation of a psychoeducative program for patients under HAART at Rabat University Hospital. The study aimed at assessing the program's impact on adherence to antiretroviral medication, knowledge of HIV/AIDS and HAART, quality of life, and biological parameters. It included patients under treatment for at least 2 months that benefited from 3 to 5 educational and psychological support sessions. Data were collected at baseline, 3 and 6 months. In all, 50 patients were included. The mean age was 38 years; 52% were illiterate and 62% unemployed. Adherence scores were high at baseline (98%) and showed no significant change throughout the study. Knowledge of HAART and HIV/AIDS, and quality of life improved significantly both at months 3 and 6. Significant increase for CD4 count rates and decrease for viral load rates were also reported. The program had no significant impact on adherence but substantively developed patients' knowledge of HIV/AIDS and HAART and improved their quality of life.

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Efavirenz or nevirapine in three-drug combination therapy with two nucleoside-reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral-naïve individuals

Mbuagbaw¹,

Irlam

Spaulding

et al. 2010

Cochrane Database of Systematic Reviews

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A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India

Abstract: Provision of free NNRTI-based combination therapy to patients in Kerala, India, resulted in greater than 90% adherence leading to better clinical outcomes in terms of increasing CD4 counts and low mortality, for patients consistently attending a treatment clinic.

Cited by 11 publications

References 32 publications

Adherence to antiretroviral therapy in India: A systematic review and meta-analysis

Adherence to antiretroviral therapy in India: A systematic review and meta-analysis

Impact of a Psychoeducative Intervention on Adherence to HAART among Low-Literacy Patients in a Resource-Limited Setting: The Case of an Arab Country—Morocco

Efavirenz or nevirapine in three-drug combination therapy with two nucleoside-reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral-naïve individuals

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