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Compliance with antiretroviral multidrug therapy in HIV-infected patients and reasons for non-compliance.
Lorenzen T; Stoehr A; Weitner L; Adam A; Jarke J; Plettenberg A; AK St.
December 30, 1998
Unique Identifier : AIDSLINE ICA12/98398662

OBJECTIVE: To analyse the compliance with antiretroviral multidrug therapy in HIV-infected patients corresponding to number of pills, recommended frequency to take the drugs and the reasons for noncompliance. METHODS: In an open prospective study HIV-infected patients were asked anonymously for prescribed antiretroviral therapy, daily time schedule and number of pills to take. In addition they were asked how often they missed some pills or deviated from the recommended schedule in the past week. Furthermore the reasons for missing the drugs should be specified. For all patients basal demographic and immunological data were collected. RESULTS: 214 patients were included. The median age was 40 years, median CD4-cells were 260c/microliter, the median viral load was 2500 copies/mm3. The median duration on any antiretroviral therapy was 23 months and 13 months for protease inhibitors. 55 out of 185 patients (30%) did not take all prescribed antiretroviral pills for at least one day and 100 out of 177 (56%) deviated from the recommended schedule for at least one day in the week before. By analysing subgroups no differences in compliance could be found regarding to number of pills, number of daily doses, duration of antiretroviral therapy, number of CD4-cells and viral load, 41 of 55 patients (75%) not taking all prescribed pills and 59 of 100 patients (59%) who deviated from the recommended schedule declared that they just forgot their medication. 33% of the patients (18/55) respectively 19% (19/100) announced an acute episode of illness, heavy side effects of the drugs or not enough information about possible side effects. CONCLUSION: Patient compliance is an important factor to achieve best results in treating HIV-infection. Our study demonstrates that about 50% of patients did not take all prescribed antiRetroviral drugs in the previous week or deviated from the recommended schedule. The most frequent reason was forgetfulness of the patients. Unexpectedly we were unable to find differences in compliance by analysing subgroups in regard to number of antiretroviral pills, number of daily doses or duration of therapy.

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