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Inicio Farmacia Hospitalaria (English Edition) Evolution of antiretroviral treatment adherence from 2000 to 2008
Información de la revista
Vol. 34. Núm. 6.
Páginas 279-283 (Enero 2010)
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Vol. 34. Núm. 6.
Páginas 279-283 (Enero 2010)
Acceso a texto completo
Evolution of antiretroviral treatment adherence from 2000 to 2008
Evolución de la adherencia al tratamiento antirretroviral del 2000 al 2008
Visitas
...
O. Ibarra Barruetaa,
Autor para correspondencia
, A. Urrutia Losadaa, A. López de Torre Querejazua, J. Mayo Suárezb, E. Martínez Gutiérrezb, M.J. Martínez-Bengoecheaa
a Servicio de Farmacia, Hospital de Galdakao-Usansolo, Bizkaia, Spain
b Servicio de Infecciosas, Hospital de Galdakao-Usansolo, Bizkaia, Spain
Información del artículo
Abstract
Objectives

To evaluate antiretroviral treatment adherence in the HIV patient cohort of our hospital and observe their evolution over a 9-year period, and to determine the individual pattern of adherence over time.

Methods

Descriptive study of the evolution of average annual adherence and the annual percentage of adherent patients greater than 95% from 2000 to 2008. We analysed the individual pattern of adherence over time and patients were classified as ‘consistently adherent’, ‘consistently non-adherent’, and ‘fluctuating’.

Results

In the analysis of 577 patients, baseline adherence was significantly greater in naïve patients compared to those who were pre-treated.

Average annual adherence increased slightly and stayed at values around 95%. As with the percentage of patients with adherence greater than 95%, which increased from 64% in 2000 to 79% in 2008.

In terms of the individual pattern of adherence over time, of the 468 patients analysed, the majority (59%) were consistently adherent, 4% non-adherent, and the rest (37%) fluctuated in their adherence.

Conclusions

In our cohort, the overall adherence values remained steady over time and even show a positive trend, which is likely to be the result of systematic monitoring of adherence and implementation strategies to maintain adherence.

Keywords:
Adherence
Antiretroviral therapy
Acquired immunodeficiency syndrome (AIDS)
Human immunodeficiency virus (HIV)
Resumen
Objetivos

Evaluar la adherencia al tratamiento antirretroviral en la cohorte de pacientes VIH de nuestro hospital y ver su evolución a lo largo de 9 años, así como conocer el patrón individual de la adherencia con el tiempo.

Métodos

Estudio descriptivo de la evolución de la adherencia media anual y el porcentaje anual de pacientes con adherencias superiores al 95%, desde el 2000 al 2008. Se analizó el patrón individual de adherencia con el tiempo y se clasificó a los pacientes en adherentes consistentes, no adherentes consistentes y fluctuantes.

Resultados

En el análisis de 577 pacientes, la adherencia basal fue significativamente mayor en los pacientes naive respecto a los pretratados.

La adherencia media anual aumentó ligeramente y se mantuvo en valores cercanos al 95%, al igual que el porcentaje de pacientes con adherencia superior al 95%, que aumentó desde el 64% en el 2000 al 79% en 2008.

En cuanto al patrón individual de adherencia con el tiempo, de los 468 pacientes analizados, la mayoría (59%) fueron adherentes consistentes, un 4% no adherente y el resto (37%) presentaban fluctuaciones en su adherencia.

Conclusiones

En nuestra cohorte los valores de adherencia global se mantienen con el tiempo e incluso presentan una tendencia positiva, resultado de una monitorización sistemática de la adherencia e implantación de estrategias dirigidas a mantener la adherencia.

Palabras clave:
Adherencia
Terapia antirretroviral
Síndrome de la inmunodeficiencia humana adquirida (sida)
Virus de la inmunodeficiencia humana
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References
[1.]
Recomendaciones de GESIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (actualización enero de 2007). Panel de expertos de Gesida y Plan Nacional del Sida. Enferm Infecc Microbiol Clin. 2007;25:32-53.
[2.]
D.L. Paterson, S. Swindells, J. Mohr, M. Brester, E.N. Vergis, C. Squier, et al.
Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.
Ann Intern Med, 133 (2000), pp. 21-30
[3.]
D.R. Bangsberg.
Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression.
Clin Infect Dis, 43 (2006), pp. 939-941
[4.]
Recomendaciones GESIDA/SEFH/PNS para mejorar la adherencia al tratamiento antiretroviral [accessed 6/2008]. Available from: http://www.gesida.seimc.org/pcientifica/fuentes/DcyRc/Gesida_dcyrc2008_adherenciaTAR.pdf.
[5.]
S. Rueda, L.Y. Park-Wyllie, A.M. Bayoumi, A.M. Tynan, T.A. Antoniou, S.B. Rourke, et al.
Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS (Review).
Cochrane Database Syst Rev, 3 (2006), pp. CD001442
[6.]
J.M. Simoni, C.R. Pearson, D.W. Pantalone, G. Marks, N. Crepaz.
Efficacy of intervencions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load.
J Acquir Immune Defic Syndr, 43 (2006), pp. S23-S35
[7.]
N. Singh, C. Squier, C. Sivek, M. Wagener, M.H. Nguyen, V.L. Yu.
Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: prospective assessment with implications for enhancing compliance.
AIDS Care, 8 (1996), pp. 261-269
[8.]
C.A. Kleeberger, J. Buechner, F. Palella, R. Detels, S. Riddler, R. Godfrey, et al.
Changes in adherence to highly active antiretroviral therapy medications in the Multicenter AIDS Cohort Study.
AIDS, 18 (2004), pp. 683-688
[9.]
D.A. Murphy, M. Belzer, S.J. Durako, M. Sarr, C.M. Wilson, L.R. Muenz.
Longitudinal antiretroviral adherence among adolescents infected with human immunodeficiency virus.
Arch Pediatr Adolesc Med, 159 (2005), pp. 764-770
[10.]
Ibarra MO, Corcostegui B, Peral J, Mayo J, Mora O, Martínez-Bengoechea MJ. Efficacy of AMA intervention to improve HIV medication adherence. Oral abstract. 3rd International Conference on HIV treatment adherence. Jersey City 2008.
[11.]
E.M. Gardner, W.J. Burman, M.E. Maravi, A.J. Davidson.
Selective drug taking during combination antiretroviral therapy in an unselected clinic population.
J Acquir Immune Defic Syndr, 40 (2005), pp. 294-300
[12.]
A.E. Deschamps, S. De Geest, A.M. Vandame, H. Bobbaers, W.E. Peetermans, E. Van Wijngaerden.
Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards.
AIDS Patient Care, 22 (2008), pp. 1-9
[13.]
J.A. Muñoz- Moreno, C.R. Fumaz, M.J. Ferrer, A. Tuldrà, T. Rovira, C. Viladrich, et al.
Assessing self-reported adherence to HIV therapy by questionnaire: The SERAD (Self-reported adherence) Study.
AIDS Res Hum retroviruses, 23 (2007), pp. 1166-1175
[14.]
M. Lazo, S.J. Gange, T.E. Wilson, K. Anastos, D.G. Ostrow, M.D. Witt, et al.
Patterns and predictors of changes in adherence to highly active antiretroviral therapy: longitudinal study of men and women.
Clin Infect Dis, 45 (2007), pp. 1377-1385
[15.]
V.D. Lima, R. Harrigan, D.R. Bangsberg, R.S. Hogg, R. Gross, B. Yip, et al.
The combined effect of moderm highly active antiretroviral therapy regimens and adherence on mortality over time.
J Acquir Immune Defic Syndr, 50 (2009), pp. 529-536
[16.]
V. Cooper, G. Gellaitry, M. Hankins, M. Fisher, R. Horne.
The influence of symptom experiences and attributions on adherence to highly active antiretroviral therapy (HAART): a six- month prospective, follow-up study.
AIDS Care, 21 (2009), pp. 520-528
[17.]
L.N. Schonnesson, P.M. Diamond, M.W. Ross, M. Williams, G. Bratt.
Baseline predictors of three types of antiretroviral therapy (ART) adherence: a 2- year follow-up.
AIDS Care, 4 (2006), pp. 406-414
[18.]
Ibarra Barrueta MO, Martínez Gutiérrez E, Mayo Suárez J, Gabilondo Zelaia I. Adherence can be maintained over time after intensive intervention. 4th International Conference on HIV treatment adherence Miami. 2009.
[19.]
N.J. Ostrop, K.A. Hallett, J. Gill.
Long- term patient adherence to antiretroviral therapy.
Ann Pharmacother, 34 (2000), pp. 703-709
[20.]
O. Ibarra Barrueta, L. Ortega Valín, on behalf of Grupo VIH de la SEFH.
Encuesta de la situación de la Atención Farmacéutica en el paciente VIH en España.
Farm Hosp, 32 (2008), pp. 196-203
[21.]
R. Gross, B. Yip, V. Lo Re, E. Wood, C.S. Alexander, P.R. Harrigan, et al.
A simple, dynamic measure of antiretroviral therapy adherence predicts failure to maintain HIV-1 suppression.
J Infect Dis, 194 (2006), pp. 1108-1114
[22.]
R. Grossberg, Y. Zhang, R. Gross.
A time-to- prescription- refill measure of antiretroviral adherence predicted changes in viral load in HIV.
J Clin Epidemiol, 57 (2004), pp. 7-1110
[23.]
E.M. Gardner, W.J. Burman, M.E. Maravi, A.J. Davidson.
Durability of adherence to antiretroviral therapy on initial and subsequent regimens.
AIDS Patient Care STDS, 20 (2006), pp. 628-636
[24.]
W.C. Holmes, W.B. Bilker, H. Wang, J. Chapman, R. Gross.
HIV/AIDSspecific quality of life and adherence to antiretroviral therapy over time.
J Acquir Inmune Defic Syndr, 46 (2007), pp. 323-327

This study was presented as an Oral Communication, number CT4, in the 5th Sei Norte Conference, held in San Sebastian from 7–9 May 2009.

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