Pill count has the greatest impact on adherence, survey reports
The total number of pills that need to be taken every day in HAART therapy has the greatest impact on adherence of 10 characteristics studied, according to a survey of HIV positive individuals, nearly two-thirds of whom had experienced at least three treatment regimens. The findings of the Perspectives on Adherence and Simplicity for HIV+ Patients on Antiretroviral Therapy (PASPORT) survey were presented here today at the 40th Annual Meeting of the Infectious Diseases Society of America (IDSA).
Of the 10 attributes evaluated in the survey, total pills per day had a mean attribute importance score of 14 percent, followed by dosing frequency (13 percent), adverse events (12 percent), diet restrictions (11 percent), pill size (10 percent); number of refills (9 percent) number of insurance co-pays (9 percent), number of prescriptions (8 percent) number of medication bottles (8 percent) and the requirement of bedtime dosing (6 percent).
In addition to assessing the relative impact on anticipated adherence of dosing characteristics, the survey participants also evaluated seven triple-HAART regimens frequently prescribed for patients with HIV, including three regimens comprising QD medications. The regimens were evaluated individually, and also in head-to-head paired comparisons in which each of the seven regimens was compared with every other regimen, for a total of 21 comparisons. Information about the specific attributes of each regimen, and pictures and symbols were used to indicate features such as food requirements, pill size, number of pills and adverse event profiles.
Neither the brand nor the generic names of the medications were mentioned and identifying markers were obscured. The data collected in the survey are not necessarily representative of all HIV+ individuals. The survey population included 299 HIV+ patients ranging in age from 17 to 72 (median 43), 76 percent of whom were males. African Americans comprised approximately 45 percent of participants, Caucasians 38 percent, Hispanics 15 percent and Asian and other ethnic groups made up the remainder. The survey was conducted in six U.S. cities with a high proportion of citizens infected with HIV (Seattle, San Francisco, Miami, New York City, Atlanta and Washington, D.C.).
All individuals who participated in the survey were treatment-experienced with the majority having been on HAART regimens for four years or more. Of 295 patients who responded to a question on their current level of adherence, 26 percent reported no doses missed in the past three months. Another 32 percent said they had missed 1 or 2 doses; 24 percent said 3 to 5, 8 percent said 6 to 8, and 10 percent said 9 or more.
Elaine Salewske | EurekAlert!
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