Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes.

Walsh, J.C., Horne, R., Dalton, M., Burgess, A.P. and Gazzard, B.G. (2001) Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. AIDS Care, 13 (6). pp. 709-720. 10.1080/09540120120076878 .

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DOI: 10.1080/09540120120076878

Abstract

The objective of the study was to define common reasons for non-adherence (NA) to highly active antiretroviral therapy (HAART) and the number of reasons reported by non-adherent individuals. A confidential questionnaire was administered to HIV-seropositive patients taking proteinase inhibitor based HAART. Median self-reported adherence was 95% (n = 178, range = 60-100%). The most frequent reasons for at least 'sometimes' missing a dose were eating a meal at the wrong time (38.2%), oversleeping (36.3%), forgetting (35.0%) and being in a social situation (30.5%). The mean number of reasons occurring at least 'sometimes' was 3.2; 20% of patients gave six or more reasons; those reporting the lowest adherence reported a significantly greater numbers of reasons (rho = - 0.59; p < 0.001). Three factors were derived from the data by principal component analysis reflecting 'negative experiences of HAART', 'having a low priority for taking medication' and 'unintentionally missing doses', accounting for 53.8% of the variance. On multivariate analysis only the latter two factors were significantly related to NA (odds ratios 0.845 and 0.849, respectively). There was a wide spectrum of reasons for NA in our population. The number of reasons in an individual increased as adherence became less. A variety of modalities individualized for each patient are required to support patients with the lowest adherence.

Item Type:Article
Uncontrolled Keywords:HIV AIDS; patients; risk; survey methods; treatment
Departments, units and centres:Department of Practice and Policy > Centre for Behavioural Medicine
ID Code:2212
Journal or Publication Title:AIDS Care
Deposited By:Library Staff
Deposited On:17 Jun 2011 14:45
Last Modified:17 Jun 2011 14:45

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