title: Palatability, adherence and prescribing patterns of antiretroviral drugs for children with human immunodeficiency virus infection in Canada.
abstract: OBJECTIVE
  To assess the impact of perceived palatability of antiretroviral drugs on adherence to therapy of children infected by human immunodeficiency virus and on prescribing patterns by their caring physicians.
  
  
  METHODS
  
  
  
  METHODS
  Two arms--retrospective chart review and a cross-sectional survey.
  
  
  METHODS
  Tertiary-care pediatric human immunodeficiency virus clinic during a 17-year period.
  
  
  METHODS
  Children with human immunodeficiency virus infection and physicians actively caring for children with human immunodeficiency virus infection in seven provinces in Canada were surveyed regarding their perception of the palatability of 8-liquid and 15 non-liquid antiretroviral medications and its effect on drug selection.
  
  
  METHODS
  Effect of taste preferences of antiretroviral drugs on adherence to treatment by infected children and on drug selection by their caring physicians.
  
  
  RESULTS
  Forty of 119 children (34%) refused at least once to an antiretroviral medication. In 5%, treatment was discontinued because of poor palatability. Ritonavir was the least palatable drug (50% of children; p = 0.01). Ritonavir use (OR 4.80 [95%CI 1.34-17.20]) and male gender (OR 7.25 [95%CI 2.30-22.90]) were independent predictors of drug discontinuation because of poor taste. Physicians also perceived liquid ritonavir as the least palatable (p = 0.01) and the most likely to be discontinued (p = 0.01). However, they commonly prescribed it as first-line therapy (p = 0.06).
  
  
  CONCLUSIONS
  A third of children infected with human immunodeficiency virus fail to adhere to their treatment because of poor drug taste. Physicians are aware of that, but this does not prevent them from selecting the least palatable drugs as first-line therapy.
authors.affiliation: Division of Emergency Medicine, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Daren
authors.initials: D
authors.lastname: Lin
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Seabrook
authors.forename: Doreen M
authors.initials: DM
authors.lastname: Matsui
authors.forename: Susan M
authors.initials: SM
authors.lastname: King
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rieder
authors.forename: Yaron
authors.initials: Y
authors.lastname: Finkelstein
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002170:Canada; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D055118:Medication Adherence; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019438:Ritonavir / Q000008:administration & dosage / Q000627:therapeutic use; D012737:Sex Factors; D013649:Taste
chemical_list: D019380:Anti-HIV Agents; D019438:Ritonavir