title: Efficacy of an educational and counseling intervention on adherence to highly active antiretroviral therapy: French prospective controlled study.
abstract: OBJECTIVE
  The objective was to evaluate the impact of an intervention for improving adherence to antiretroviral therapies (HAART) in HIV-infected patients.
  
  
  METHODS
  We designed a prospective, controlled, randomized trial to assess the impact of an educational and counseling intervention in addition to standard of care. At M0, the study enrolled 244 HAART-treated patients who attended a medical consultation between September and December 1999 who were not included in another protocol. Patients in the intervention group (IG) were offered three individual sessions by trained nurses. The proportions of adherent patients at 6 months followup (M6) and the change in HIV RNA between M0 and M6 were measured.
  
  
  RESULTS
  Between M0 and M6, HIV RNA significantly decreased in the 123 patients of the IG (mean difference = -0.22 log [+/-0.86], p =.013), while it increased (+0.12 log [+/-0.90], p =.14) in the 121 patients of the control group. However, the proportion of patients with HIV RNA <40 copies/mL remained similar in both groups. In an intent-to-treat analysis, the only significant predictor of 100% adherence at M6 was the intervention group (p =.05) after adjustment for baseline adherence (p =.001). Among the 202 patients with available data on adherence, the proportion of adherent patients was similar in both groups at M0 (58% vs. 63%, p =.59) but became higher in the IG at M6 (75% vs. 61%, p =.04).
  
  
  CONCLUSIONS
  The educational and counseling intervention was efficient for increasing adherence to HAART and could be implemented in most clinical settings.
authors.affiliation: INSERM U379, Marseilles, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Pradier
authors.forename: Laurence
authors.initials: L
authors.lastname: Bentz
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: Catherine
authors.initials: C
authors.lastname: Tourette-Turgis
authors.forename: Michel
authors.initials: M
authors.lastname: Morin
authors.forename: Marc
authors.initials: M
authors.lastname: Souville
authors.forename: Maryline
authors.initials: M
authors.lastname: Rebillon
authors.forename: Jean-Gabriel
authors.initials: JG
authors.lastname: Fuzibet
authors.forename: Alain
authors.initials: A
authors.lastname: Pesce
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Moatti
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D012367:RNA, Viral / Q000097:blood; D011795:Surveys and Questionnaires
chemical_list: D012367:RNA, Viral