Difficulties Reported by Hiv-Infected Patients Using Antiretroviral Therapy in Brazil

Abstract

OBJECTIVE: To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION: Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS: Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS: Among 406 patients initiating treatment, 350 (86.2%) and 209 (51.5%) returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm³) and high (> 4) adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills), use of other medications, high (> 4) adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS: A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol

Self-rated health by HIV-infected individuals undergoing antiretroviral therapy in Brazil

“…These side effects were mentioned by great part of the sample and showed a negative association with good self-rated health, especially among women. According to a study carried out in Belo Horizonte, Brazil, side effects/adverse reactions were one of the main difficulties in adhere to treatment 32 .…”

Quality of life of HIV+ patients undergoing pharmacotherapeutic follow-up

“…In this study, problems of adherence to ART and adverse reactions were the most common problems related to specific pharmacotherapy. These issues hamper the clinical management of patients and the achievement of positive outcomes and have been observed in several other studies (Walsh et al, 2001;Bartlett, 2002;Padua et al, 2007;Guimarães et al, 2008). The pharmaceutical interventions were focused on the category "Patient Education", in line with the profile of the patients, and consisted of educational measures that stress the importance of drug therapy and adherence to it.…”

Avaliação da adesão e qualidade de vida de portadores de HIV sob seguimento farmacoterapêutico / Evaluation of adhesion and quality of life of HIV carriers under pharmacoterapeutical follow up

“…As principais di iculdades relatadas foram as seguintes: as reações adversas; o fato de o regime terapeû-tico ser complexo; e o fato de esquecer de tomar os medicamentos. Isso reforça ainda mais a necessidade da atuação do farmaceûtico trabalhando em conjunto com a equipe multipro issional no sentido de reduzir essas di iculda- 16 des e alcançar uma melhor adesão ao tratamento. Uma das limitações do estudo refere-se ao número amostral pequeno, e por isso faz-se necessário ampliá-lo.…”