Marseille 2007
| Abstract #520 - Treatment Switching - impact on the patient | ||||
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Session: 42.6: Wellbeing and quality of life (Parallel) on Tuesday @ 16.30-18.30 in Auditorium/Overflow Chaired by Anna Liguori, Richard Harding Authors: Presenting Author: Prof Lorraine Sherr - UCL, United Kingdom |
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| Additional Authors: Dr Richard Harding, Dr Fiona Lampe, Ms Heather Leake-Date, Ms Sally Norwood, Dr Jane Anderson, Dr Simon Edwards, Dr Gilly Arthur, Dr Martin Fisher, Dr Sarah Zetler, Prof Margaret Johnston, | ||||
| Aim: Aim. :- Explore treatment switching experience for patients receiving antiretroviral treatment | ||||
| Method / Issue: 778 consecutive HIV positive patients attending 5 centres (London , South-East) completed a cross sectional inventory to examine HIV treatment decisions, satisfaction, switching rates and triggers, stopping, treatment adherence, symptoms, quality of life, risk behaviour and doctor patient satisfaction. | ||||
| Results / Comments: 77% of all patients were eligible and 86% returned completed data. 155 (20.8%) were treatment-nave, 623 (79.2%) had taken ART - 161(21.6%) on first treatment, 135 (18.1%) one switch, 196 (26.3%) multiple switches and 99 (13.3%) had stopped treatment. Switching triggers clustered into four main trigger groups Side effects, Difficulties with the medications, Toxicity and Resistance. The most common major reasons for switching treatment were Not keeping the amount of virus down (26.1%), Concerns about the future effect of medicine (24.1%), Body shape changes (20.4%), Issues about resistance (19.3%) and Feeling sick/nausea (18.5%). Gay males were more likely to be multiple switchers and heterosexual females were more likely to be treatment nave. Heterosexual males were less likely to be treatment nave, and more frequently non-switchers. Multiple switchers were more likely to be white, UK born and lived in the UK for > 5 years. Generally Treatment Nave, Non-switchers and One-switchers reported lower symptoms and higher qol. Multiple Switchers reported higher physical symptom burden (p=0.003) a higher global distress (p=.002) higher psychological symptoms (p=0.03) and a higher global distress score (p=0.002). Multiple switchers had lower quality of life p=0.02). 63% of switches were doctor driven, 21% patient driven. | ||||
| Discussion: Treatment switching is common, and multiple switching has become more prevalent. Patient experience and decision making around such switches affects satisfaction, adherence and is related to symptom burden, which is high | ||||
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