Marseille 2007
| Abstract #467 - PREDICTORS OF ADHERENCE TO ANTI-RETROVIRAL THERAPY IN AN ITALIAN SAMPLE OF HIV+ SUBJECTS | ||||
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Session: 24.6: Adherence (Parallel) on Monday @ 16.30-18.30 in HC Chaired by Ana Josefina Guell, Rahul Battcharya Authors: Presenting Author: Dr Raffaele Visintini - H San Raffaele Turro, Vita Salute University, Italy |
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| Additional Authors: Dr Alessandro Ubbiali, Dr Deborah Donati, Dr Carlo Chiorri, Dr Elisabetta Cattaneo, Dr Valentina Bregani, | ||||
| Aim: This study was carried out in order to identify factors that could negatively influence HIV+ patients adherence to anti-retroviral therapies with the aim to reduce this severe phenomenon, whose psycho-social and economic costs are well known and more and more evident in the time. | ||||
| Method / Issue: A self-administered battery of tests including a Socio-demographic Schedule, a Questionnaire on Anti-retroviral therapy Taking (QUF), the Attachment Style Questionnaire (ASQ) and the Multidimensional Health Locus of Control Form C (MHLC-C), was administered to 478 HIV+ subjects. By choosing as a cut-off issue the 95% of correct therapy taking during the last month, the total sample of subject was then divided in Adherent (N=268; 56.1%) and Non-adherent (N=210; 43.9%) patients. In order to identify possible predictors of adherence to anti-retroviral therapy, a Logistic Regression Model was used to assess the association between the dependent variable (Adherence vs Non-adherence) and a set of independent variables (Predictors) including both socio-demographic and psychological features of the patients. | ||||
| Results / Comments: The results of this study identified as possible significant predictors linked to adherence the following list of variables: Number of anti-retroviral therapy taking pro die (OR: 4.161, 95% CI 2.542, 6.811), Anti-retroviral therapy Side Effects (OR 0.519, 95% CI 0.328, 0.821), Incompatibility of taking anti-retroviral therapy with daily activities (OR 0.290, 95% CI 0.197, 0.427), Forgetfulness of taking anti-retroviral therapy (OR 0.304, 95% CI 0.230, 0.402) and Self-evaluated compliance score in taking anti-retroviral therapy (OR 1.440, 95% CI 1.152, 1.798). The model correctly predicted 77.5% of non-adherent and 82.4% of adherent subjects (c2(452) = 308.151, p = .998). | ||||
| Discussion: A first important result of this study, concerns the relevant role played by Anti-retroviral therapy Side Effects in determining Adherence vs Non-adherence to treatment according to almost the majority of previous in scientific literature studies on this topic. On the other hand, the variable Number of anti-retroviral therapy taking pro die showed to have a linkage with adherence that seems in disagreement with many previous scientific findings. In particular, the probability of a subject to be Adherent seems to rise consistently with the mounting of the number of the daily therapy taking as shown by observing that almost the majority of patients needing to take their anti-retroviral therapy in four or more administrations, were totally Adherent. These data seem to suggest that a higher number of treatment takings, spread during the daytime, could lead the subject to constantly arrange his time and life-style with anti-retroviral therapy taking rate, therefore diminishing the probability of being non-adherent. Finally the performed analyses on the variable Self-evaluated compliance score in taking anti-retroviral therapy showed that only those subjects with the top possible total score were then included in the 95% of adherence group of patients, while any possible lower score was related to more and more decreasing adherence rates. This result recommend to consider all the patients self-evaluating their therapy taking differently then at best as at high risk for being non-adherent and therefore needing for a very careful clinical monitoring. In conclusion and according to pervious findings, this study confirm the significant link between the adherence phenomenon and the anti-retroviral therapy taking regime, underlining the opportunity for physicians to better focus on the complexity of variables to be considered both when at first prescribing treatment and during time. | ||||
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