title: Adherence to HAART therapy measured by electronic monitoring in newly diagnosed HIV patients in Botswana.
abstract: OBJECTIVE
  This pilot study was designed to evaluate the feasibility and benefits of electronic adherence monitoring of antiretroviral medications in HIV patients who recently started Highly Active Anti Retroviral Therapy (HAART) in Francistown, Botswana and to compare this with self-reporting.
  
  
  METHODS
  Dosing histories were compiled electronically using Micro Electro Mechanical Systems (MEMS) monitors to evaluate adherence to prescribed therapies. Thirty patients enrolled in the antiretroviral treatment program were monitored over 6 weeks. These patients were all antiretroviral (ARV) naïve. After each visit (mean three times) to the pharmacy, the data compiled by the monitors were downloaded. Electronic monitoring of adherence was compared to patient self-reports of adherence.
  
  
  RESULTS
  The mean individual medication adherence level measured with the electronic device was 85% (range 21-100%). The mean adherence level measured by means of self-reporting was 98% (range 70-100%). Medication prescribed on a once-a-day dose base was associated with a higher adherence level (97.9% for efavirenz) compared with a twice-a-day regimen (88.4% for Lamivudine/Zidovudine).
  
  
  CONCLUSIONS
  It is feasible to assess treatment adherence of patients living in a low resource setting on HAART by using electronic monitors. Adherence, even in the early stages of treatment, appears to be insufficient in some patients and may be below the level required for continuous inhibition of viral replication. This approach may lead to improved targeting of counselling about their medication intake of such patients in order to prevent occurrence of resistant viral strains due to inadequate inhibition of viral replication. In this pilot study a significant difference between the data recorded through the electronic monitors and those provided by self-reporting was observed.
authors: Centre for Human Drug Research, Department of Clinical Pharmacology, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Reinout
authors: R
authors: Vriesendorp
authors: Adam
authors: A
authors: Cohen
authors: Paulus
authors: P
authors: Kristanto
authors: Bernard
authors: B
authors: Vrijens
authors: Pande
authors: P
authors: Rakesh
authors: Bene
authors: B
authors: Anand
authors: Henry Uchechukwaka
authors: HU
authors: Iwebor
authors: Jacobus
authors: J
authors: Stiekema
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001902:Botswana; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods*; D004581:Electronics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012646:Self Administration / Q000706:statistics & numerical data*
chemical_list: D019380:Anti-HIV Agents