Efficacy of an educational and counseling intervention on adherence to highly active antiretroviral therapy: French prospective controlled study.
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.
Pradier
Christian
C
INSERM U379, Marseilles, France.
Bentz
Laurence
L
Spire
Bruno
B
Tourette-Turgis
Catherine
C
Morin
Michel
M
Souville
Marc
M
Rebillon
Maryline
M
Fuzibet
Jean-Gabriel
JG
Pesce
Alain
A
Dellamonica
Pierre
P
Moatti
Jean-Paul
JP
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
D012367:RNA, Viral