Monthly unannounced pill counts for monitoring HIV treatment adherence: tests for self-monitoring and reactivity effects.
BACKGROUND
Unannounced home-based pill counts conducted in person or on the telephone are reliable and valid for monitoring medication adherence. However, expecting to have one's pills counted, organizing medications for pill counts, and increased attention from the person conducting the pill counts may have reactive effects and inadvertently improve adherence. The current study determined whether monthly unannounced pill counts conducted by telephone influence adherence over time.


METHODS
Two prospective cohorts, one drawn from a social support condition in a behavioral intervention trial (n=186) and the other an observational study (n=187), were followed for 12 months and 8 months, respectively. Medication adherence was monitored using monthly unannounced pill counts conducted by telephone. In addition, blood plasma viral load was collected at the final pill count for the observational cohort.


RESULTS
Analyses did not indicate increases in medication adherence over time for antiretroviral or psychiatric medications among men, women, people with detectable and undetectable viral loads, and various medication regimens.


CONCLUSIONS
Unannounced pill counts conducted by telephone do not demonstrate reactivity effects and remain a viable, unobtrusive, objective method of monitoring medication adherence.
Department of Psychology, University of Connecticut, Storrs, Connecticut 06269, USA. seth.k@uconn.edu
Seth C
SC
Kalichman
Christina
C
Amaral
Connie
C
Swetsze
Lisa
L
Eaton
Moira O
MO
Kalichman
Chauncey
C
Cherry
Mervi
M
Detorio
Angela M
AM
Caliendo
Raymond F
RF
Schinazi
D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000097:blood / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012651:Self Medication / Q000706:statistics & numerical data; D012944:Social Support; D013689:Telephone; D019562:Viral Load; D055815:Young Adult; D016903:Drug Monitoring
D044966:Anti-Retroviral Agents
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