title: Medication adherence in people dually treated for HIV infection and mental health conditions: test of the medications beliefs framework.
abstract: Beliefs about medication necessity and concerns predict treatment adherence in people with a wide-array of medical conditions, including HIV infection. However, medication beliefs have not been examined in people dually treated with psychotropic medications and antiretroviral therapy. In the current study, we used a prospective design to investigate the factors associated with adherence to psychotropic medications and antiretrovirals among 123 dually treated persons living with HIV. We used unannounced phone-based pill counts to monitor adherence to psychiatric and antiretroviral medications over a 6-week period. Hierarchical regression models included demographic, health and psychosocial characteristics as predictors of adherence followed by medication necessity and concerns beliefs. Results showed that medication necessity beliefs predicted both antiretroviral and psychiatric medication adherence over and above established predictors of adherence. Medication concerns also predicted psychotropic adherence, but not antiretroviral adherence. These models accounted for 31 and 22 % of the variance in antiretroviral and psychotropic adherence, respectively. Findings suggest that the necessity-concerns medication beliefs framework has utility in understanding adherence to multiple medications and addressing these beliefs should be integrated into adherence interventions.
authors.affiliation: Department of Psychology, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269, USA, seth.k@uconn.edu.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pellowski
authors.forename: Christopher
authors.initials: C
authors.lastname: Kegler
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D012944:Social Support
references.citation: Acta Psychiatr Scand. 2009 Jan;119(1):78-84
references.pmid: 18983630
references.citation: Liver Int. 2013 Jul;33(6):894-903
references.pmid: 23581550
references.citation: AIDS Behav. 2010 Apr;14(2):252-62
references.pmid: 20013043
references.citation: Psychiatry Res. 2011 Mar 30;186(1):128-32
references.pmid: 20843557
references.citation: Prim Care Respir J. 2011 Jun;20(2):118-9
references.pmid: 21597663
references.citation: Adm Policy Ment Health. 2011 Sep;38(5):335-44
references.pmid: 20976619
references.citation: AIDS Care. 2011 Nov;23(11):1360-5
references.pmid: 22022846
references.citation: Ann Behav Med. 2012 Apr;43(2):189-97
references.pmid: 22076697
references.citation: Curr Opin Psychiatry. 2013 Sep;26(5):446-52
references.pmid: 23880592
references.citation: AIDS Behav. 2013 Oct;17 Suppl 2:S118-27
references.pmid: 23673792
references.citation: BMC Psychiatry. 2013;13:260
references.pmid: 24125027
references.citation: PLoS One. 2013;8(12):e80633
references.pmid: 24312488
references.citation: PLoS One. 2014;9(5):e95469
references.pmid: 24798428
references.citation: Int J Behav Med. 2015 Apr;22(2):214-22
references.pmid: 25081100
references.citation: Subst Use Misuse. 2000 May-Jun;35(6-8):869-90
references.pmid: 10847215
references.citation: Int J STD AIDS. 2000 Sep;11(9):579-85
references.pmid: 10997499
references.citation: Psychol Assess. 2000 Sep;12(3):346-53
references.pmid: 11021159
references.citation: J Gen Intern Med. 2002 Oct;17(10):812-3
references.pmid: 12390559
references.citation: J Behav Med. 2003 Aug;26(4):315-32
references.pmid: 12921006
references.citation: Int J STD AIDS. 2004 Jan;15(1):38-44
references.pmid: 14769170
references.citation: J Acquir Immune Defic Syndr. 2004 Aug 15;36(5):1109-10
references.pmid: 15247568
references.citation: Addiction. 1993 Jun;88(6):791-804
references.pmid: 8329970
references.citation: Int J STD AIDS. 1996;7 Suppl 2:75-82
references.pmid: 8799801
references.citation: AIDS Behav. 2006 Sep;10(5):541-52
references.pmid: 16721506
references.citation: J Gen Intern Med. 2007 Jul;22(7):1003-6
references.pmid: 17390095
references.citation: J Acquir Immune Defic Syndr. 2007 Jul 1;45(3):334-41
references.pmid: 17514019
references.citation: Ann Behav Med. 2007 Aug;34(1):46-55
references.pmid: 17688396
references.citation: Int J Drug Policy. 2007 Aug;18(4):288-95
references.pmid: 17689377
references.citation: Int Rev Psychiatry. 2008 Feb;20(1):95-101
references.pmid: 18240066
references.citation: J Acquir Immune Defic Syndr. 2008 Mar 1;47 Suppl 1:S15-9
references.pmid: 18301129
references.citation: AIDS Patient Care STDS. 2008 May;22(5):403-11
references.pmid: 18373416
references.citation: Psychosom Med. 2008 Jun;70(5):539-45
references.pmid: 18519880
references.citation: HIV Clin Trials. 2008 Sep-Oct;9(5):298-308
references.pmid: 18977718
references.citation: AIDS Behav. 2012 Nov;16(8):2119-43
references.pmid: 22644066
references.citation: AIDS. 2012 Dec;26 Suppl 2:S117-35
references.pmid: 23303434
references.citation: Inflamm Bowel Dis. 2009 Jun;15(6):837-44
references.pmid: 19107771