Marseille 2007
Marseille 2007
Abstract book
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Abstract #175  -  EVALUATION OF DIFFERENT HAART ADHERENCE INTERVENTION STRATEGIES BY PATIENTS, HIV-NEGATIVE SIGNIFICANT OTHERS, AND HIV-CARING PROFESSIONALS.
Session:
  26.72: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Dr Maria Paola Trotta - INMI "L. Spallanzani", Italy
 
  Additional Authors:  MD Maria Paola Trotta, Psy Marina Giulianelli, MD Patrizia Marconi, MD Adriana Ammassari,  
Aim:
A number of interventions based on specific HAART adherence support measures have been evaluated with rather limited results. It is well known that non-adherence is associated to treatment-, patient- and health care-related factors, but the relevance of single components yet needs to be established. This study was conducted to assess which interventions to improve adherence are considered key strategies by HIV-positive and HIV-negative persons, as well as different professionals.
 
Method / Issue:
A list of 14 interventions to improve HAART adherence has been evaluated. The study was carried out in two phases: first, all HIV-positive participants in the adherence sub-study of the I.Co.N.A. cohort (Ad.I.Co.N.A.) were asked to indicate those interventions which could enhance their adherence. Second, the intervention list was shown to a small focus group of HIV-positive subject, some HIV-negative persons considered as significant others by those joining the group, psychologists, and HIV-caring physicians. The list of adherence interventions included the following: reduction of pills and/or doses, better management of side-effects, more information aids, more time dedicated to adherence during clinic visit, telephone service for therapy information, temporal treatment interruption, more simple drug collection, meeting with a psychologist, involvement of family members or friends, use of an alarm clock as reminder, self-help groups, meeting with a social worker, individual meeting with a nurse, treatment of drug/alcohol addiction. Results obtained in the Ad.I.Co.N.A. are summarized in frequencies. The other persons contributing to the study were asked to rank (most important=1; least important=14) the single interventions cited on the list. The preferred interventions were then summarized as follows: HAART, side effects, adherence, non infectious diseases professionals, family- or self-help, addiction treatment. For the Ad.I.Co.N.A. patients and the other interviews, only the three most frequent or the three first rankings were considered, as appropriate.
 
Results / Comments:
The three most frequently cited adherence interventions by the participants in the Ad.I.Co.N.A. (n=298) were: reduction of pills and/or doses (46.0%), better management of side-effects (30.5%), more information aids (25.5.%). Management of side effects scored as the most important for the HIV-positive participating in the small focus group (n=4). Also the HIV-negative significant others and the psychologists ranked management of side effects at the first place equally with action on HAART in case of the significant others (n=8) and with action on adherence in case of the psychologists (n=3). Physicians (n=6) indicated action on adherence as priority followed by first action on HAART and then on management of side-effects.
 
Discussion:
HIV-positive persons and their significant others identify in management of side-effects and action on HAART the most important areas of intervention for improvement of HAART adherence. Physicians experts in HIV care and psychologists consider action on adherence itself the most appropriate approach for enhancing proper drug intake. The preliminary results of this study underline that effective intervention strategies need to broaden the approach taking into account treatment-related factors in addition to adherence support. After this pilot experience undertaken to test the methodology, the collection of a bigger number of interviews is ongoing.
 
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