| Title |
Highly specific reasons for nonadherence to antiretroviral therapy: results from the German adherence study
|
|---|---|
| Published in |
Patient preference and adherence, November 2017
|
| DOI | 10.2147/ppa.s141762 |
| Pubmed ID | |
| Authors |
Johanna Boretzki, Eva Wolf, Carmen Wiese, Sebastian Noe, Annamaria Balogh, Anja Meurer, Ivanka Krznaric, Alexander Zink, Christian Lersch, Christoph D Spinner |
| Abstract |
Reasons for and frequency of nonadherence to antiretroviral therapy (ART) may have changed due to pharmacological improvements. In addition, the importance of known non-pharmacologic reasons for nonadherence is unclear. We performed a cross-sectional, noninterventional, multicenter study to identify current reasons for nonadherence. Patients were categorized by physicians into the following adherence groups: good, unstable, or poor adherence. Co-variables of interest included age, sex, time since HIV diagnosis, ART duration, current ART regimen, HIV transmission route, comorbidity, HIV-1 RNA viral load (VL), and CD4 cell count. Patients self-reported the number of missed doses and provided their specific reasons for nonadherent behavior. Statistical analyses were performed using Fisher's extended exact test, Kruskal-Wallis test, and logistic regression models. Our study assessed 215 participants with good (n=162), unstable (n=36), and poor adherence (n=17). Compared to patients with good adherence, patients with unstable and poor adherence reported more often to have missed at least one dose during the last week (good 11% vs unstable 47% vs poor 63%, p<0.001). Physicians' adherence assessment was concordant with patients' self-reports of missed doses during the last week (no vs one or more) in 81% cases. Similarly, we found a strong association of physicians' assessment with viral suppression. Logistic regression analysis showed that "reduced adherence" - defined as unstable or poor - was significantly associated with patients <30 years old, intravenous drug use, history of acquired immune deficiency syndrome (AIDS), and psychiatric disorders (p<0.05). Univariate analyses showed that specific reasons, such as questioning the efficacy/dosing of ART, HIV stigma, interactive toxicity beliefs regarding alcohol and/or party drugs, and dissatisfaction with regimen complexity, correlated with unstable or poor adherence (p<0.05). Identification of factors associated with poor adherence helps in identifying patients with a higher risk for nonadherence. Reasons for nonadherence should be directly addressed in every patient, because they are common and constitute possible adherence intervention points. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 80 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 80 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 14 | 18% |
| Student > Doctoral Student | 8 | 10% |
| Student > Ph. D. Student | 7 | 9% |
| Researcher | 6 | 8% |
| Student > Bachelor | 4 | 5% |
| Other | 12 | 15% |
| Unknown | 29 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 14% |
| Nursing and Health Professions | 9 | 11% |
| Psychology | 8 | 10% |
| Social Sciences | 5 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 5% |
| Other | 9 | 11% |
| Unknown | 34 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 January 2018.
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#22,764,772
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Outputs from Patient preference and adherence
#1,648
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Outputs of similar age
#299,290
of 340,752 outputs
Outputs of similar age from Patient preference and adherence
#22
of 23 outputs
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