Self-reported nonadherence with antiretroviral drugs predicts persistent condition

R. Murri, A. Ammassari, A. De Luca, A. Cingolani, P. Marconi, A. W. Wu, A. Antinori

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To assess variables predictive of nonadherence persisting over time in HIV-infected people treated with highly active antiretroviral therapy. Method: Prospective study of consecutive HIV-infected patients who were prescribed ritonavir- or indinavir-containing regimens in a university-based HIV clinic in Rome. A patient questionnaire assessing knowledge of treatment regimen, adherence behavior, reasons for taking and missing therapy, factors influencing adherence, and health behaviors was administered at baseline and 1 year later. A predose protease inhibitor plasma level was measured concurrently. Persistent nonadherence was defined as patient self-reported nonadherence both at enrollment and at follow-up questionnaires. Results: From April 1998 to July 1998, 140 patients were enrolled into the study. At follow-up, 10% remained persistently nonadherent, and 15% of the previously adherent patients became nonadherent. On bivariate analysis, being less than 35 years old (odds ratio [OR] 8.9; 95% Cl 1.8-43.1; p = .002), self-reporting nonadherence at enrollment (OR 14.5; 95% Cl 3.5-5.8; p < .001), and having experienced "a fair amount" or "a lot" of vomiting (OR 11.1; 95% Cl 1.6-74.7; p = .02) or pruritus (OR 16.4; 95% Cl 2.6-102.8; p = .004) during the 4 weeks before enrollment were significantly correlated to persistent nonadherence. Conclusion: Previous self-reported nonadherence was a strong predictor of persistent nonadherence during follow-up. Moreover, being of younger age and self-reporting vomiting or pruritus were also associated with a higher risk of nonadherence persisting over time.

Original languageEnglish (US)
Pages (from-to)323-329
Number of pages7
JournalHIV Clinical Trials
Volume2
Issue number4
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Adherence
  • Protease inhibitors
  • Self-report

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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