Assessing and achieving readiness to initiate HIV medication

Nordqvist, Ola; Södergård, Björn; Tully, Mary P.; Sönnerborg, Anders; Lindblad, Åsa Kettis

doi:10.1016/j.pec.2005.09.014

Cited by 39 publications

(45 citation statements)

References 62 publications

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“…In order for this to happen a process containing five components need to occur: The patients' attitudes towards the treatment need to change, the patient should find the right health care provider, create a support system, gain (Enriquez, et al, 2004). In this theory (Enriquez, et al, 2004), trigger events are assumed to initiate positive health behavior change (Nordqvist, Sodergard, Tully, Sonnerborg, & Lindblad, 2006). In our study, however, trigger events led to discontinuation of ART and the move to traditional medicine or religion instead of a positive health behavior change.…”

Section: Discussionmentioning

confidence: 99%

The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

et al. 2011

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Section: Discussionmentioning

confidence: 99%

The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

et al. 2011

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“…In 2005, an important step was the recognition of both the intentional and unintentional aspects of nonadherence to medications [95][96][97][98][99]. Both facets need to be addressed simultaneously to solve this important health care problem.…”

Section: Figurementioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

230

316

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Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications' , 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation' , 'Implementation' and 'Discontinuation' . In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.

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“…For a detailed description of readiness and its measurement, see Nordquist et al [14] and Grimes et al [15].…”

Section: Introductionmentioning

confidence: 99%

“…Several instruments have been used to measure readiness in other conditions [22][23][24][25][26] but only four instruments have been used in HIV [27][28][29]. None have been used in routine care, [14,15] but Willey´s 2-item readiness assessment, has been used in several research projects [28,30]. already prescribed HIV medication [28], 15% were not ready for treatment according to the Willey´s 2-item readiness assessment but were still prescribed antiretroviral treatment.…”

Section: Introductionmentioning

confidence: 99%

“…In order to take timely measures to motivate the patient if the degree of readiness is declining, but before adherence is affected, repeated measurements of readiness throughout treatment would be helpful, if readiness has adherence predictive properties. The readiness assessments used so far have mainly been for research purposes so little is known about the degree of readiness in clinical practice as well as which factors are influencing readiness [14,15].…”

Section: Introductionmentioning

confidence: 99%

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The Degree of Readiness among a Population of HIV Infected Patients in Sweden

Södergård¹,

Halvarsson²,

Sönnerborg³

et al. 2016

HIV Curr Res

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Objective: The objectives were to assess the degree of readiness for HIV infected patients currently on treatment and to evaluate factors potentially influencing readiness.Methods: All HIV-treated patients, who attended a HIV clinic in Sweden, during 7 months, were asked to complete a questionnaire containing Willey´s 2-item readiness assessment and questions about other factors potentially affecting readiness. The Willey´s 2-item readiness assessment categorises patients into either of five stages of change. Patients categorized as in the action or maintenance stage were classified as 'ready to adhere to medicines'. Results:In total 327 patients participated (response rate 87.4%). The proportion categorised as in the action and maintenance stage was 97%. Factors associated with readiness were lower mean CD4 count at start of treatment and lack of resistance. The proportion with viral loads below detection limit was very high (91%). Conclusion:Although the initiation of ART is extremely important, to ensure good treatment results, follow-up and motivation throughout the treatment are also important. Continuous measurement of the patients´ readiness to maintain treatment adherence needs to be further explored.

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Assessing and achieving readiness to initiate HIV medication

Cited by 39 publications

References 62 publications

The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

A New Taxonomy for Describing and Defining Adherence to Medications

The Degree of Readiness among a Population of HIV Infected Patients in Sweden

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