Predictors of antiretroviral adherence

Abstract

This study was conducted in order to help determine the key factors that predict adherence to antiretroviral medications. A total of 115 HIV/AIDS patients who were having trouble adhering to their antiretroviral regimens completed face-to-face interviews in which adherence levels, medication side effects, mental health, social support, patient-provider relationship characteristics, substance use and health anxiety were assessed. Three measures of adherence were used: adherence over the past three days, adherence over the past week, and adherence over the past month. Logistic regression analyses indicated strongest prediction of three-day adherence, with mental health, social support, patient-provider relationship characteristics and side effects contributing to prediction. Past week adherence was associated with age and social support measures, and showed a marginal association with side effects. Past month adherence was less strongly predicted, with social support and alcohol use contributing to prediction. Thus, a variety of factors were found to determine adherence, and implications of the findings for adherence models and interventions are discussed.

Sero-positive African Americans’ Beliefs about Alcohol and Their Impact on Anti-retroviral Adherence

“…Some researchers have suggested that reduced adherence to ART rather than the effects of alcohol per se may account for the disease progression (Conigliaro et al, 2003;Murphy et al, 2004;Samet et al, 2003). Findings from the study reported here support this view and we propose that the link between alcohol consumption and lower adherence may derive from purposive decision making based on beliefs about the appropriateness of drinking and taking ART, not alcohol induced forgetfulness.…”

“…Although the studies discussed above suggest that non-adherent behavior derives from alcohol-induced memory lapses (e.g., Murphy et al, 2004) or from alcohol "blurring" the importance of dose timing, another possible explanation is that patient beliefs about the deleterious effects of drinking alcohol and taking ART may contribute to non-adherence. Beliefs about ART have previously been associated with several aspects of adherence.…”

“…The authors speculate that alcohol may contribute to disease progression through non-adherence. Indeed, recently (Murphy, Marelich, Hoffman, & Steers, 2004) it was found that study participants who were light or non-drinkers were more likely to be adherent. In the Murphy study the major impact of alcohol was to reduce the ability to maintain a pill taking schedule.…”

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

“…Finally, a patient's relationship with their health care provider plays an important role in adherence (Altice et al 2001;Heisler et al 2002;Murphy et al 2004;Schneider et al 2004). In a longitudinal analysis of adherence to HIV medication, Godin et al (2005) found patient-doctor satisfaction to be a significant predictor of attitude.…”

Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong

“…However, majority of studies have focused only on the administration of prescribed dose, and have classified participants into adherers or nonadherers based on whether they take a certain percentage of prescribed medication during a time period (Catz, Kelly, Bogart, Benotsch, & McAuliffe, 2000;Chesney et al, 2000;Garcia de Olalla et al, 2002;Knobel et al, 2002). Despite the fact that adherence to instructions regarding dietary requirements, amount and schedule of medications, and lifestyle habits may also substantially influence the efficacy of medication regimens (Altice & Friedland, 1998;Murphy, Marelich, Hoffman, & Steers, 2004;Stone et al, 2001), they have not been well incorporated into the measurement of medication adherence. One recent study employed a more extensive measurement by including more aspects of adherence and found this to be valid and reliable (Reynolds et al, 2007).…”