title: Impact of a patient education program on adherence to HIV medication: a randomized clinical trial.
abstract: Patients' knowledge of their HIV condition and its treatment, which has been recognized as a factor that influences adherence to antiretroviral therapy, can be improved through educational programs. This prospective, randomized, controlled trial compared an experimental group that participated in an educational program and a control group with standard care. The study evaluated the impact of an educational intervention on adherence to antiretroviral therapy, patients' knowledge, quality of life, and therapeutic response in patients treated with highly active antiretroviral therapy. Three hundred twenty-six patients were analyzed at inclusion. A higher level of adherence was associated with patients who were older, had higher incomes, and did not smoke. CD4 cell count and plasma viral load were correlated with adherence at entry. The educational intervention had an impact on adherence and knowledge in the experimental group at 6 months, which was maintained at 12 and 18 months. A delayed increase in adherence was observed in the control group at 12 months. No significant impact on quality of life was observed over time. The patients' health status improved in 56% of the experimental group subjects and 50% of the control subjects. However, no significant impact was shown on CD4 cell count and plasma viral load. This study shows that an educational intervention improves adherence to antiretroviral regimens and health status and suggests that it should be initiated early in therapy.
authors.affiliation: Department of Internal Medicine, Bicêtre Hospital, Le Kremiln Bicetre, France. cecile.goujard@bct.ap-hop-paris.fr
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.forename: Noëlle
authors.initials: N
authors.lastname: Bernard
authors.forename: Nathalie
authors.initials: N
authors.lastname: Sohier
authors.forename: Dominique
authors.initials: D
authors.lastname: Peyramond
authors.forename: Florian
authors.initials: F
authors.lastname: Lançon
authors.forename: Judith
authors.initials: J
authors.lastname: Chwalow
authors.forename: Benoit
authors.initials: B
authors.lastname: Arnould
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Delfraissy
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life