title: A medication self-management program to improve adherence to HIV therapy regimens.
abstract: This study examined whether a self-management intervention based on feedback of adherence performance and principles of social cognitive theory improves adherence to antiretroviral dosing schedules. Forty-three individuals with HIV/AIDS who were starting or switching to a new protease inhibitor regimen were randomly assigned to be in a medication self-management program or usual care control group. The self-management program included skills development exercises, three monthly visits for medication consultations, and monthly feedback of adherence performance using electronic monitors on medication bottles. Participants also completed a 40-item questionnaire that measured self-efficacy to take medications, on schedule, in a variety of situations. Logistic regression analysis indicated that individuals in the self-management group were significantly more likely to take 80% or more of their doses each week than individuals in the control group (n=29, OR=7.8, 95% CI=2.2-28.1). Self-management training with feedback of adherence performance is a potentially useful model for improving adherence to complex regimens in HIV/AIDS care.
authors.affiliation: School of Pharmacy, Center for AIDS Research, University of North Carolina at Chapel Hill, Beard Hall, Campus Box #7360, Chapel Hill, NC 27599-7360, USA. ssmith@unc.edu
authors.forename: Scott R
authors.initials: SR
authors.lastname: Smith
authors.forename: John C
authors.initials: JC
authors.lastname: Rublein
authors.forename: Cheryl
authors.initials: C
authors.lastname: Marcus
authors.forename: Tina Penick
authors.initials: TP
authors.lastname: Brock
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Chesney
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D030141:Feedback, Psychological; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D009657:North Carolina; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012646:Self Administration / Q000379:methods* / Q000523:psychology; D020377:Self Efficacy; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors