title: An assessment of current HIV treatment adherence services in the UK.
abstract: The aim of this study was to examine current approaches to supporting adherence to antiretroviral therapy in UK HIV clinics. One hundred HIV/AIDS/GUM physicians were interviewed: 97% were personally involved in discussing adherence, spending 22% of consultation time on this issue and assessing adherence most commonly by patient self-report (88%). Other personnel involved included nurses (74%), other doctors (56%), health advisers (54%) and pharmacists (48%). Among criteria for achieving treatment success, adherence support ranked fourth after 'treatment fitting well into patient's lifestyle', regular viral load monitoring and the 'experience of the clinician/healthcare team'. A variety of tools were used to support adherence including dosette boxes (53%), written information (44%) and verbal communication (42%). Only 20% of physicians followed adherence protocols or formal guidelines. Three-quarters of physicians had received no training on adherence issues. The most common ways physicians kept informed about adherence matters were by attending conferences (87%), reading literature (71%) and learning from colleagues (51%). Eighty-seven per cent of physicians believed national adherence guidelines would be valuable. In conclusion, there is a need for training and direction within current adherence support services. National guidelines could provide a valuable framework for health care professionals.
authors.affiliation: Jefferiss Wing, St Mary's Hospital NHS Trust, London, UK. John.Walsh@St-Marys.nhs.uk
authors.forename: J C
authors.initials: JC
authors.lastname: Walsh
authors.forename: L
authors.initials: L
authors.lastname: Sherr
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D004502:Education, Medical, Continuing / Q000379:methods; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D013222:State Medicine; D006113:United Kingdom