title: The role of integrated home-based care in patient adherence to antiretroviral therapy.
abstract: Non-adherence is one of the primary obstacles to successful antiretroviral therapy in HIV+ patients worldwide. In Brazil, the Domiciliary Therapeutic Assistance is a multidisciplinary and integrated home-based assistance program provided for HIV+ patients confined in their homes due to physical deficiency. This study investigated ADT's ability to monitor and promote appropriate adherence to ARV therapy. Fifty-six individuals were recruited from three study groups: Group 1 -- patients currently in the ADT program, Group 2 -- 21 patients previously treated by the ADT program, and Group 3 -- 20 patients who have always been treated using conventional ambulatory care. Using multivariable self-reporting to evaluate adherence, patients in the ADT program had significantly better adherence than patients in ambulatory care (F = 6.66, p = 0.003). This effect was independent of demographic and socioeconomic characteristics as well as medical history. Patients in the ADT program also showed a trend towards greater therapeutic success than ambulatory patients. These results suggest the incorporation of characteristics of ADT in conventional ambulatory care as a strategy to increase adherence to ARV therapy.
authors.affiliation: Nucleo de Doenças Infecciosas, Centro Biomédico, Universidade Federal do Espírito Santo, Vitória, ES, Brazil. neilg@mail.med.upenn.edu
authors.forename: Neil
authors.initials: N
authors.lastname: Gupta
authors.forename: Angela Caulyt Santos da
authors.initials: AC
authors.lastname: Silva
authors.forename: Luciana Neves
authors.initials: LN
authors.lastname: Passos
mesh_terms: D000553:Ambulatory Care; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*
chemical_list: D019380:Anti-HIV Agents