title: Correlates of Adherence to Varenicline Among HIV+ Smokers.
abstract: BACKGROUND
  Low rates of adherence to smoking cessation pharmacotherapy may limit the effectiveness of treatment. However, few studies have examined adherence in smoking cessation trials thus, there is a limited understanding of factors that influence adherence behaviors. This brief report analyzes correlates of adherence to varenicline among people living with HIV/AIDS.
  
  
  METHODS
  Study participants were recruited from three HIV care centers in New York City and enrolled in a three-arm randomized controlled pilot study in which all subjects received varenicline. At the 1-month study visit, there were no significant differences in adherence by study condition, therefore we combined treatment arms to examine correlates of adherence (n = 127). We used pill counts to assess varenicline adherence, defined as taking at least 80% of the prescribed dose. We conducted a multivariate path analysis to assess factors proposed by the information-motivation-behavioral skills model to predict adherence.
  
  
  RESULTS
  Only 56% of smokers were at least 80% adherent to varenicline at 1 month. Adherence-related information, self-efficacy, a college degree, and non-Hispanic white race/ethnicity were associated with increased varenicline adherence. In path analysis, information and motivation were associated with increased adherence self-efficacy, and adherence self-efficacy was associated with increased adherence, but with marginal significance. These associations with adherence were no longer significant after controlling for race/ethnicity and education.
  
  
  CONCLUSIONS
  Further exploration of the role of a modifiable correlates of adherence, such as adherence-related information, motivation and self-efficacy is warranted. Interventions are needed that can address disparities in these and other psychosocial factors that may mediate poor medication adherence.
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY; donna.shelley@nyumc.org.
authors.forename: Donna
authors.initials: D
authors.lastname: Shelley
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY;
authors.forename: Tuo-Yen
authors.initials: TY
authors.lastname: Tseng
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY;
authors.forename: Mirelis
authors.initials: M
authors.lastname: Gonzalez
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY;
authors.forename: Paul
authors.initials: P
authors.lastname: Krebs
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY;
authors.forename: Selena
authors.initials: S
authors.lastname: Wong
authors.affiliation: Center for the Advancement of Health Information Technology, Research Triangle Institute, Raleigh, NC;
authors.forename: Robert
authors.initials: R
authors.lastname: Furberg
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY; Behavioral Health Research, St Luke's Roosevelt Hospital, New York, NY;
authors.forename: Scott
authors.initials: S
authors.lastname: Sherman
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY;
authors.forename: Antoinette
authors.initials: A
authors.lastname: Schoenthaler
authors.affiliation: New York University College of Nursing and Center for Drug Use and HIV Research, New York, NY.
authors.forename: Anthony
authors.initials: A
authors.lastname: Urbina
authors.affiliation: New York University College of Nursing and Center for Drug Use and HIV Research, New York, NY.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
mesh_terms: D005260:Female; D015658:HIV Infections; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009519:New York City; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D016540:Smoking Cessation / Q000379:methods*; D000068580:Varenicline / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018722:Nicotinic Agonists; D000068580:Varenicline