Telephone nurse counseling improves HIV medication adherence: an effectiveness study.
Antiretroviral therapy remains a challenge for persons living with HIV (PLWH), who must maintain high levels of adherence to prevent viral resistance and treatment failure. This effectiveness study examined a telephonic nursing program to translate well-validated cognitive-behavioral and motivational interviewing adherence counseling into routine clinical care. Participants were 98 PLWH who were followed for up to 6 months after recruitment from HIV care settings across the United States. Each participant received telephone counseling (Mdn =three sessions) from a trained nurse who followed up with the participant over time. Nurses assessed participants' readiness for adherence, provided support to overcome identified barriers, and offered information based on participants' questions. At 6 months after the start of treatment, a greater percentage of participants had adherence at or above 95% than expected for this population, based on a clinical interview. Self-efficacy was related to baseline medication adherence, whereas other clinical and demographic variables were not. Attrition was a concern but was unrelated to adherence, self-efficacy, or clinical severity measures. Telephone counseling was associated with a relatively high percentage of participants reaching target antiretroviral therapy adherence levels and may be an effective method to disseminate psychologically based counseling into a broad range of care settings.
Cook
Paul F
PF
University of Colorado-Denver, Aurora, CO, USA.
McCabe
Mishcha M
MM
Emiliozzi
Suzie
S
Pointer
Lauren
L
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology; D037001:Directive Counseling / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000451:nursing / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D015403:Nursing Evaluation Research; D010353:Patient Education as Topic; D015397:Program Evaluation; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D055817:Telenursing / Q000458:organization & administration*; D013689:Telephone; D014481:United States; D016903:Drug Monitoring