Examining the Association between Item Specific Treatment Burden and Adherence in People Living with HIV

Abstract

For the 1.1 million people with HIV (PWH) in the United States, adherence to a HIV anti-retroviral medication regimen, engagement in regular physical activity, and eating a healthy diet are essential for maintaining optimal health. However, treatment burden can increase the risk for self-management non-adherence. We analyzed data of 103 men and women diagnosed with HIV to examine the relationship between medication, physical activity, and diet-related treatment burden to corresponding measures of self-management adherence. Multivariate analysis demonstrated that one medication treatment burden item explained 11% (p=.01) of self-reported 30-day HIV anti-retroviral medication adherence; physical activity treatment burden, along with physical functioning, explained 25% (p<.001) of physical activity, measured by daily average steps; and diet-specific treatment burden was non-significant in maintaining a healthy diet, measured by a total Healthy Eating Index-2010 score. Findings demonstrate that specific treatment burden items can predict specific self-management outcome behavior in PWH.

Examining the Association between Emotional Dysregulation and Treatment Burden

“…Age was self-reported and doubled checked via patient electronic medical record (EMR). The number of total chronic conditions and the specific diagnosis of diabetes are antecedent factors contributing to higher levels of treatment burden related to an increased number of self-management activities (e.g., polypharmacy, increased self-monitoring tasks; Sav et al, 2016;Schreiner & Daly, 2020;Schreiner et al, 2020aSchreiner et al, , 2020bTran et al, 2012). Total chronic condition diagnoses, as defined by CMS (2019), and the diagnosis of diabetes (Type I and II) were abstracted from the clinic's EMR.…”

“…The amount of treatment burden a patient experiences due to this workload of health care includes tasks specific to a self-management regimen (e.g., medication administration), social relationships (e.g., reliance on caregivers, family/friend dynamics), as well as interactions between patient and the health care system (e.g., arranging appointments, wait times, patient-provider relationships; Sav et al, 2017;Tran et al, 2012Tran et al, , 2014. Furthermore, the level of treatment burden a patient experiences can either be related to the cumulative effect of managing a multitude of self-management tasks, often increasing in number and/or complexity over the trajectory of a chronic illness (Shippee et al, 2012), or be related to a specific task, such as medication administration (Schreiner et al, 2020a(Schreiner et al, , 2020b.…”

“…Treatment burden, or the perceived burden associated with adhering to a specific self-management regimen, is a factor contributing to suboptimal adherence (Sav et al, 2017; Schreiner et al, 2020a, 2020b; Tran et al, 2012) and poor health related quality of life (Eton et al, 2019) across chronic condition populations. Treatment burden is defined as “the personal workload of healthcare, including treatment and self-management of chronic health conditions, and the impact of this workload on patient functioning and well-being,” (Eton et al, 2017).…”