[Factors predicting lack of adherence to highly active antiretroviral treatment].
BACKGROUND
Knowledge of adherence to highly active antiretroviral treatment (HAART) and the variables associated with poor compliance is useful for the follow-up of HIV infected patients.


METHODS
Patients were consecutively recruited from the HIV outpatient clinics of the Hospitals of Leon and El Bierzo from January to June 2000. Patients were considered non-adherent to treatment if they failed to take 10% or more of their prescribed total dose of at least one drug during the 4 days before the interview, or if they had accumulated a delay of more than 9 days over the previous 3 months in picking up their prescribed drugs from the hospital pharmacy. Logistic regression analysis was performed with variables found to be associated with adherence in the univariate analysis.


RESULTS
The methods used to determine adherence had a Kappa index of 12.6%. Among the 206 patients interviewed, 108 were considered non-adherent (52.4%; CI 95% 5 45.6-59.2). Multivariate analysis showed that the following factors were associated with poor treatment adherence: cocaine consumption in the previous six months (adjusted OR 5 5.1); patients unsure about the proper way to take prescribed treatment; (adjusted OR 5 2.5); and patients not prescribed the zidovudine-lamivudine combination (adjusted OR 5 1.9). Over one-third of patients with no variable associated with treatment adherence were considered non-compliant.


CONCLUSIONS
Measurement of medication adherence and its predictive factors involved methodological difficulties. With the criteria used in the present study more than half the patients were considered non-compliant. The variables found to be related to poor adherence can be modified by social, psychological or health care interventions.
Martín-Sánchez
Vicente
V
Area de Medicina Preventiva y Salud Pública. Departamento de Fisiología. Universidad de León. León. Spain.
Ortega-Valín
Luis
L
Pérez-Simón
María del Rosario
Mdel R
Mostaza-Fernández
José Luis
JL
Ortiz de Urbina-González
Juan José
JJ
Rodríguez-María
Miriam
M
Carro-Fernández
José Antonio
JA
Cuevas-González
María José
MJ
Alcoba-Leza
Manuel
M
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D003625:Data Collection; D004338:Drug Combinations; D017723:Drug Utilization Review / Q000379:methods; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013030:Spain; D016312:Treatment Refusal / Q000706:statistics & numerical data; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D004338:Drug Combinations; D019259:Lamivudine; D015215:Zidovudine