Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection

Adriana Ammassari, Rita Murri, Patrizio Pezzotti, Maria Paola Trotta, Laura Ravasio, Patrizio De Longis, Sergio Lo Caputo, Pasquale Narciso, Sergio Pauluzzi, Giampiero Carosi, Salvatore Nappa, Paola Piano, Crescenzo M. Izzo, Miriam Lichtner, Giovanni Rezza, Antonella D.Arminio Monforte, Giuseppe Ippolito, Mauro Moroni, Albert W. Wu, Andrea Antinori

Research output: Contribution to journalArticle

Abstract

Objectives: To identify variables predictive of nonadherence to highly active antiretroviral therapy (HAART) and to assess whether self-reported symptoms or medication side effects are related to adherence. Design: Cross-sectional multicenter study Adherence Italian Cohort Naive Antiretrovirals [AdICONA] within the Italian Cohort Naive Antiretrovirals (ICONA). Methods: Participants receiving HAART completed a 16-item self-administered questionnaire to assess nonadherence in the last 3 days as well as the type and intensity of 24 common HIV- and HAART-related symptoms experienced during the last 4 weeks. Results: From May 1999 to March 2000, 358 persons were enrolled: 22% reported nonadherence and were less likely to have HIV RNA ≤500 copies/ml (odds ratio = 0.51; 95% confidence interval: 0.31-0:85). Frequency of moderate/severe symptoms or medication side effects in nonadherent participants ranged from 3.6% to 30%. On univariate analysis, nausea, anxiety, confusion, vision problems, anorexia, insomnia, taste perversion, and abnormal fat distribution were significantly associated with nonadherence. Nonadherent persons had a higher mean overall symptom score (12.3 ± 9.2 versus 8.1 ± 6.6; p ≤ .001) and mean medication side effect score (2.9 ± 2.7 versus 1.9 ± 1.9; p ≤ .001) when compared with adherent participants. In the multivariate analysis, nausea (p = .003); anxiety (p = .006); younger age (p = .007); unemployment (p ≤ .001); not recalling name, color, and timing of drugs (p = .009); running out of pills between visits (p = .002); and being too busy (p = .03) were independently associated with nonadherence in the last 3 days. Conclusions: In addition to patient characteristics, medication-related variables, and reasons for nonadherence, patient-reported symptoms and medication side effects were significantly associated with adherence to HAART.

Original languageEnglish (US)
Pages (from-to)445-449
Number of pages5
JournalJournal of acquired immune deficiency syndromes
Volume28
Issue number5
DOIs
StatePublished - Dec 15 2001

Keywords

  • AIDS
  • Adherence
  • HAART
  • HIV
  • Medication side effects
  • Symptoms

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Ammassari, A., Murri, R., Pezzotti, P., Trotta, M. P., Ravasio, L., De Longis, P., Caputo, S. L., Narciso, P., Pauluzzi, S., Carosi, G., Nappa, S., Piano, P., Izzo, C. M., Lichtner, M., Rezza, G., Monforte, A. D. A., Ippolito, G., Moroni, M., Wu, A. W., & Antinori, A. (2001). Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. Journal of acquired immune deficiency syndromes, 28(5), 445-449. https://doi.org/10.1097/00042560-200112150-00006