Number of daily pills, dosing schedule, self-reported adherence and health status in 2010: a large cross-sectional study of HIV-infected patients on antiretroviral therapy

HIV Med. 2013 Mar;14(3):153-60. doi: 10.1111/j.1468-1293.2012.01046.x. Epub 2012 Sep 20.

Abstract

Objectives: The aim of the study was to assess whether pill burden is associated with self-reported adherence to current combination antiretroviral regimens and health status in a large sample of unselected and chronically treated HIV-infected patients.

Methods: An adherence and health status questionnaire was offered to all patients collecting their drugs between March and May 2010 at our clinic; both parameters were primarily evaluated using a visual analogue scale. Linear correlations were evaluated using Spearman's correlation coefficient. Wilcoxon's rank-sum test and the χ(2) test were used to compare quantitative and qualitative variables. The generalized linear model was used in multivariable analyses.

Results: Among 2763 subjects on treatment during the study period, 2114 (78.8% male; mean age 46.9 ± 8.84 years) were tested for adherence; 1803 (85.3%) had viral loads < 50 HIV-1 RNA copies/mL. After adjusting for age, gender, HIV risk factor, current CD4 count, pill burden and dosing interval, adherence was higher in patients with undetectable HIV RNA (P < 0.0001) and directly associated with current CD4 count (P = 0.029). After adjusting for the same variables, health status was better in patients with undetectable viraemia (P = 0.004) and in men who have sex with men (MSM) and heterosexuals compared with injecting drug users and those with other risk factors (P < 0.0001 for MSM and P = 0.008 for heterosexuals); it was also directly associated with current CD4 count (P < 0.0001) and inversely associated with age (P < 0.0001) and pill burden (P = 0.019).

Conclusions: In this highly adherent population, the number of daily pills was related to self-reported health status but not to self-reported adherence, whereas the dosing interval did not influence self-reported adherence or health status.

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives*
  • Anti-HIV Agents / administration & dosage*
  • Antiretroviral Therapy, Highly Active
  • Atazanavir Sulfate
  • CD4 Lymphocyte Count
  • Carbamates / administration & dosage*
  • Cross-Sectional Studies
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Dideoxynucleosides / administration & dosage*
  • Drug Administration Schedule
  • Drug Combinations
  • Drug Therapy, Combination
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Female
  • Furans
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Humans
  • Italy / epidemiology
  • Lamivudine / administration & dosage*
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Nevirapine / administration & dosage*
  • Oligopeptides / administration & dosage*
  • Organophosphates / administration & dosage*
  • Organophosphonates / administration & dosage*
  • Oxazines / administration & dosage*
  • Pyridines / administration & dosage*
  • Self Report
  • Sulfonamides / administration & dosage*
  • Surveys and Questionnaires
  • Viral Load

Substances

  • Anti-HIV Agents
  • Carbamates
  • Dideoxynucleosides
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Furans
  • Oligopeptides
  • Organophosphates
  • Organophosphonates
  • Oxazines
  • Pyridines
  • Sulfonamides
  • abacavir, lamivudine drug combination
  • Deoxycytidine
  • Lamivudine
  • Atazanavir Sulfate
  • Nevirapine
  • Adenine
  • fosamprenavir