title: Memory-based strategies for antiretroviral medication management: an evaluation of clinical predictors, adherence behavior awareness, and effectiveness.
abstract: "Forgetting" is the most commonly endorsed reason for missing an antiretroviral therapy (ART) dose, yet little is known about the prevalence, predictors, and effectiveness of the mnemonic strategies to support ART adherence. The current study assessed 28 self-reported memory-based medication strategies in 233 HIV-infected individuals with 30-day ART adherence measured via the medication event monitoring system. Participants endorsed using multiple (8.7 ± 5.6) strategies with the most common being internally-driven. More frequent strategy use was uniquely associated with affective distress, dependent daily functioning, higher non-ART pill burden, and poorer ART adherence. Individuals who used strategies frequently, but perceived them as minimally effective, had more affective, physical, and functional distress. More frequent strategy use was associated with worse ART adherence and was unrelated to perceived effectiveness. Primary reliance on internally-based mnemonic strategies may reflect a lack of awareness of adherence behaviors and may be insufficient to support optimal ART adherence in vulnerable populations.
authors.affiliation: California Joint Doctoral Program in Clinical Psychology, San Diego State University/University of San Diego, San Diego, CA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Blackstone
authors.forename: S P
authors.initials: SP
authors.lastname: Woods
authors.forename: E
authors.initials: E
authors.lastname: Weber
authors.forename: I
authors.initials: I
authors.lastname: Grant
authors.forename: D J
authors.initials: DJ
authors.lastname: Moore
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001364:Awareness; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D015438:Health Behavior; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D017010:Reminder Systems / Q000706:statistics & numerical data; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents