13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

UNDERSTANDING FULL ADHERENCE

HIV Med 2007; 8(Suppl. 1):5 (abstract no. O17)

Lorraine Sherr¹, Richard Harding², Sally Norwood¹, Heather Leake Date³, Margaret Johnson⁴, Gilly Arthur⁵, Simon Edwards⁶, Jane Anderson⁷, Sarah Zetler⁷ and Fiona Lampe^1
1Royal Free and University College Medical School, London, UK, ²King’s College, London, UK, ³Royal Sussex County Hospital, Brighton, UK, ⁴Royal Free, London, UK, ⁵Archway, London, UK, ⁶Mortimer Market, London, UK, ⁷The London/ Homerton, London, UK

AIM: This study was set up to examine adherence to antiretroviral treatment in a cohort of UK patients in London and the South East and to monitor full adherence and its implications.

METHOD: Consecutive attenders at five HIV clinics participated in a cross sectional questionnaire study. All patients who were not too ill to be approached and spoke sufficiently fluent English to complete the standardized inventories and were currently on treatment (n=502) were included (86% response rate). Adherence was measured by self recall over the preceding week with a notation of medication-taking as well as adherence to time and special circumstance provisions. Quality of life, disclosure, risky behaviour and demographic information was also gathered.

RESULTS: A total of 441 (79.1%) reported dose adherence >95%. However 42.8% had not taken their dose at the correct time, and 27.2% had not taken it under the correct circumstances, reducing full adherence from 79.1% to 41.5%. Comparisons of fully adherent dose + circumstance (41.5%), partially adherent dose only (36.1%) and not adherent (22.4%) showed a significant effect for age (younger people less adherent, F=7.8, P<0.001), residency (37.3% of non-UK born fully adherent versus 47.5% UK born, F=6.8, P<0.03), ethnicity (White 46.0% versus 36.1% for non-White, F=5.3, P<0.07), quality of life (significantly higher for fully adherent, X²=8.7, P<0.01), psychological and global symptom burden higher for non adherent (Psych=X²=15.2, P<0.001; GD X²=6.9, P<0.03). Non-adherence among multiple switchers was 45.1%, single switchers 23.5% and first treatment 31.4%. Multivariate analysis to look at predictors of full adherence showed younger age (OR=0.96, P<0.02), education (OR=0.54, P<0.03), number of sexual partners (OR=0.27, P<0.001), having risky sex (OR=4.30, P<0.002), being optimistic about treatments (OR=0.42, P<0.01), experience of physical symptoms (OR=0.56, P<0.05) and psychological symptoms (OR=2.37, P<0.001) were associated with lowered adherence.

CONCLUSION: Combinations that avoid timing and circumstance requirements will enhance adherence. Interventions can be targeted at those who may find full adherence a challenge.

2007-03-29
O17

Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD