Decisional capacity and medication adherence among youth with HIV

Abstract

This exploratory study examined the degree to which decisional capacity (DC) is associated with measures of self-reported medication adherence. We hypothesized that youth with higher levels of DC would report greater levels of antiretroviral medication adherence. Seventy-two (72) youth with HIV aged 13-24 participated in this study. Data collection included administration of the MacArthur Competence Tool for Treatment and measures of adherence (i.e., seven-day self-report interview, visual analog scale, and biological indicators). Data were analyzed using descriptive statistics, intercorrelations, and multiple and Poisson regression analyses. Youth with HIV who exhibited greater understanding of their disease were more likely to report fewer missed doses in the last seven days. Findings build upon literature in the areas of DC and health literacy and highlight the potential utility of enhancing HIV disease understanding among youth with HIV.

Can sharing improve caring? A call to prioritize shared decision making in pediatric pain management.

“…SDM facilitates collaborative deliberation about options available and ultimately promotes the choice of an evidence-based treatment that best aligns with the family and child’s values and needs (Chenneville et al, 2015; Klok et al, 2015; Miller & Jawad, 2014; Ngadimon et al, 2017). As demonstrated in the broader pediatric literature, prioritizing SDM results in a greater likelihood that families will opt in favour of the optimal evidence-based treatment option for the child, and HCPs are more likely to share the range of available evidence-based options.…”

Feasibility and Acceptability of the Adherence Connection Counseling, Education, and Support (ACCESS) Proof of Concept: A Peer-Led, Mobile Health (mHealth) Cognitive Behavioral Antiretroviral Therapy (ART) Adherence Intervention for HIV-Infected (HIV+) Adolescents and Young Adults (AYA)

“…Decreased access to care (e.g., travel difficulty), HIV discrimination, and public stigma are important structural barriers affecting ART adherence [11][12][13][14][15]. Increased knowledge and understanding of HIV disease is associated with fewer missed ART doses [16], and self-efficacy predicts both motivational readiness for ART and ART adherence levels. Further, social support predicts self-efficacy [10].…”