Medicines information and adherence in HIV/AIDS patients.
BACKGROUND
Providing written medicines information is being legislated in an increasing number of countries worldwide, with the patient information leaflet (PIL) being the most widely used method for conveying health information. The impact of providing such information on adherence to therapy is reportedly unpredictable. Therapy for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and related opportunistic infections usually involves polytherapy and complex regimens, both of which are risk factors for non-adherence. The objective of this study was to assess the impact of medicines information on adherence to chronic co-trimoxazole therapy in low-literate HIV/AIDS patients.


METHODS
Two different PILs were designed for co-trimoxazole tablets and were available in both English and isiXhosa. Participants were randomly allocated to a control group (receiving no PIL), group A (receiving a "complex PIL") and group B (receiving a "simple PIL" incorporating pictograms). At the first interview, demographic data were collected and the time, date and day that the participant would take his/her first tablet of the month's course was also documented. In a follow-up interview adherence to therapy was assessed using two methods; self-report and tablet count.


RESULTS
The medicines information materials incorporating simple text and pictograms resulted in significantly improved adherence to therapy in the short term, whereas a non-significant increase in adherence was associated with the availability of the more complex information. This was shown by both the self-reported assessment as well as the tablet count.


CONCLUSIONS
This research suggests that appropriately designed written material can have a positive impact in improving adherence and, together with verbal consultation, are essential for enabling patients to make appropriate decisions about their medicine taking.
Mansoor
L E
LE
Faculty of Pharmacy, Rhodes University, Grahamstown 6140, South Africa.
Dowse
R
R
D000163:Acquired Immunodeficiency Syndrome; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D004348:Drug Labeling; D004522:Educational Status; D005260:Female; D015658:HIV Infections; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D013019:South Africa; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination