Medication adherence in people dually treated for HIV infection and mental health conditions: test of the medications beliefs framework

Abstract

Beliefs about medication necessity and concerns predict treatment adherence in people with a wide-array of medical conditions, including HIV infection. However, medication beliefs have not been examined in people dually treated with psychotropic medications and antiretroviral therapy. In the current study, we used a prospective design to investigate the factors associated with adherence to psychotropic medications and antiretrovirals among 123 dually treated persons living with HIV. We used unannounced phone-based pill counts to monitor adherence to psychiatric and antiretroviral medications over a 6-week period. Hierarchical regression models included demographic, health and psychosocial characteristics as predictors of adherence followed by medication necessity and concerns beliefs. Results showed that medication necessity beliefs predicted both antiretroviral and psychiatric medication adherence over and above established predictors of adherence. Medication concerns also predicted psychotropic adherence, but not antiretroviral adherence. These models accounted for 31% and 22% of the variance in antiretroviral and psychotropic adherence, respectively. Findings suggest that the necessity-concerns medication beliefs framework has utility in understanding adherence to multiple medications and addressing these beliefs should be integrated into adherence interventions.

Prevalence and predictors of medication non-adherence among people living with multimorbidity: a systematic review and meta-analysis

“… 137 among people with three or more chronic conditions. Two studies used pill counts, with non-adherence ranging from 46.3% 101 to 70.0%. 176 …”

Smartphone Applications for Educating and Helping Non-motivating Patients Adhere to Medication That Treats Mental Health Conditions: Aims and Functioning

“…Moreover, the Necessity-Concern model refers to how patients compromise their concerns against their perceived necessity to take their medication and has clinical benefit on explaining non-adherence (Horne and Weinman, 1999 ). One study suggests that this model may explain non-adherence more than any other risk factor (Kalichman et al, 2015 ). These models constitute useful frameworks when evaluating the effectiveness of interventions aiming at changing intentional non-adherence.…”

Impact of HIV care facility characteristics on the cascade of care in HIV-infected patients in the Netherlands

“…The majority of studies addressing this issue has focused on patient characteristics. Identified patient-level barriers to engagement in the HIV care continuum include mental health issues [3,4], substance use [5,6], perceived HIV stigma [7,8], and unstable housing [9][10][11]. Reported systemic barriers include factors such as lack of insurance coverage [12][13][14][15] or poor infrastructure [16][17][18][19].…”