title: Prevalence and correlates of nonadherence to antiretroviral therapy in a population of HIV patients using Medication Event Monitoring System.
abstract: Nonadherence to antiretroviral therapy (ART) jeopardizes good clinical outcome in people living with HIV. In a single-center prospective study, prevalence and correlates of nonadherence were investigated in 43 patients on ART. Nonadherence was assessed using Medication Event Monitoring System (MEMS), self-report and collateral report of treating physicians. Based on MEMS data, median taking adherence, dosing adherence, and timing adherence was 98% (interquartile range [IQR] = 5.3), 91.5% (IQR = 18), and 86% (IQR = 31.5), respectively. The median number of drug holidays per 100 days was 0.8 (IQR = 4.8). The prevalence of nonadherence measured by MEMS was 40%. Self-reported nonadherence and collateral report of nonadherence by physicians varied from 5% to 41% and 24% to 28%, respectively. Patients were categorized as adherent or nonadherent based on a clinically validated algorithm derived from MEMS parameters. Nonadherent patients used significantly more escaping coping strategies (p = 0.003) and planned problem solving strategies (p = 0.049), were prescribed significantly more antiretroviral medications (p = 0.02) and were significantly longer on ART (p = 0.04) than adherent patients. Identified correlates of nonadherence may help clinicians in detecting patients with HIV at risk for nonadherence and can support the development of adherence enhancing interventions.
authors.affiliation: University Hospitals KU-Leuven, Department of Internal Medicine, Leuven, Belgium.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Deschamps
authors.forename: Veerle D E
authors.initials: VD
authors.lastname: Graeve
authors.forename: Eric
authors.initials: E
authors.lastname: van Wijngaerden
authors.forename: Veerle
authors.initials: V
authors.lastname: De Saar
authors.forename: Anne-Mieke
authors.initials: AM
authors.lastname: Vandamme
authors.forename: Kristien
authors.initials: K
authors.lastname: van Vaerenbergh
authors.forename: Helga
authors.initials: H
authors.lastname: Ceunen
authors.forename: Herman
authors.initials: H
authors.lastname: Bobbaers
authors.forename: Willy E
authors.initials: WE
authors.lastname: Peetermans
authors.forename: Peter J
authors.initials: PJ
authors.lastname: de Vleeschouwer
authors.forename: Sabina
authors.initials: S
authors.lastname: de Geest
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007182:Income; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012944:Social Support; D016312:Treatment Refusal / Q000706:statistics & numerical data*
chemical_list: D044966:Anti-Retroviral Agents