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Antiretroviral adherence program in HIV patients : a feasibility study in the Swiss HIV Cohort Study
JournalItem (Reviews, Editorials, Rezensionen, Urteilsanmerkungen etc. in einer wissenschaftlichen Zeitschrift)
 
ID 1198099
Author(s) Krummenacher, Isabelle; Cavassini, Matthias; Bugnon, Olivier; Spirig, Rebecca; Schneider, Marie P; Swiss HIV Cohort Study
Author(s) at UniBasel Spirig, Rebecca
Year 2010
Title Antiretroviral adherence program in HIV patients : a feasibility study in the Swiss HIV Cohort Study
Journal Pharmacy world & science
Volume 32
Number 6
Pages 776-86
Keywords Antiretroviral therapy, Electronic drug monitoring, Feasibility studies, HIV, Intervention, Medication adherence, Motivational interviewing, Pharmacists, Switzerland
Abstract Objective To evaluate the feasibility of a comprehensive, interdisciplinary adherence program aimed at HIV patients. Setting Two centers of the Swiss HIV Cohort Study: Lausanne and Basel. Method 6-month, pilot, quasi-experimental, 2-arm design (control and intervention). Patients starting a first or second combined antiretroviral therapy line were invited to participate in the study. Patients entering the intervention arm were proposed a multifactorial intervention along with an electronic drug monitor. It consisted of a maximum of six 30-min sessions with the interventionist coinciding with routine HIV check-up. The sessions relied on individualized semi-structured motivational interviews. Patients in the control arm used directly blinded EDM and did not participate in motivational interviews. Main outcome measures Rate of patients' acceptance to take part in the HIV-adherence program and rate of patients' retention in this program assessed in both intervention and control groups. Persistence, execution and adherence. Results The study was feasible in one center but not in the other one. Hence, the control group previously planned in Basel was recruited in Lausanne. Inclusion rate was 84% (n = 21) in the intervention versus 52% (n = 11) in the control group (P = 0.027). Retention rate was 91% in the intervention versus 82% in the control group (P = ns). Regarding adherence, execution was high in both groups (97 vs. 95%). Interestingly, the statistical model showed that adherence decreased more quickly in the control versus the intervention group (interaction group × time P < 0.0001). Conclusion The encountered difficulties rely on the implementation, i.e., on the program and the health care system levels rather than on the patient level. Implementation needs to be evaluated further; to be feasible a new adherence program needs to fit into the daily routine of the centre and has to be supported by all trained healthcare providers. However, this study shows that patients' adherence behavior evolved differently in both groups; it decreased more quickly over time in the control than in the intervention group. RCTs are eventually needed to assess the clinical impact of such an adherence program and to verify whether skilled pharmacists can ensure continuity of care for HIV outpatients.
Publisher KNMP
ISSN/ISBN 0928-1231
edoc-URL http://edoc.unibas.ch/dok/A6008246
Full Text on edoc No
Digital Object Identifier DOI 10.1007/s11096-010-9437-2
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/20862544
ISI-Number WOS:000286436600014
Document type (ISI) Journal Article, Multicenter Study
 
   

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