Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes

J.C. Walsh, R. Horne, M. Dalton, A.P. Burgess, B.G. Gazzard

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The objective of the study was to define common reasons for non-adherence (NA) to highly active antiretroviral therapy (HAART) and the number of reasons reported by non-adherent individuals. A confidential questionnaire was administered to HIV-seropositive patients taking proteinase inhibitor based HAART. Median self-reported adherence was 95% (n = 178, range = 60-100%). The most frequent reasons for at least 'sometimes' missing a dose were eating a meal at the wrong time (38.2%), oversleeping (36.3%), forgetting (35.0%) and being in a social situation (30.5%). The mean number of reasons occurring at least 'sometimes' was 3.2; 20% of patients gave six or more reasons; those reporting the lowest adherence reported a significantly greater numbers of reasons („ = - 0.59; p < 0.001). Three factors were derived from the data by principal component analysis reflecting 'negative experiences of HAART', 'having a low priority for taking medication' and 'unintentionally missing doses', accounting for 53.8% of the variance. On multivariate analysis only the latter two factors were significantly related to NA (odds ratios 0.845 and 0.849, respectively). There was a wide spectrum of reasons for NA in our population. The number of reasons in an individual increased as adherence became less. A variety of modalities individualized for each patient are required to support patients with the lowest adherence.
Original languageEnglish
Pages (from-to)709-720
Number of pages12
JournalAIDS Care
Volume13
Issue number6
Publication statusPublished - Dec 2001

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Highly Active Antiretroviral Therapy
Therapeutics
Principal Component Analysis
Meals
Peptide Hydrolases
Multivariate Analysis
Eating
Odds Ratio
HIV
Population

Cite this

Walsh, J. C., Horne, R., Dalton, M., Burgess, A. P., & Gazzard, B. G. (2001). Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. AIDS Care, 13(6), 709-720.
Walsh, J.C. ; Horne, R. ; Dalton, M. ; Burgess, A.P. ; Gazzard, B.G. / Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. In: AIDS Care. 2001 ; Vol. 13, No. 6. pp. 709-720.
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Walsh, JC, Horne, R, Dalton, M, Burgess, AP & Gazzard, BG 2001, 'Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes', AIDS Care, vol. 13, no. 6, pp. 709-720.

Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. / Walsh, J.C.; Horne, R.; Dalton, M.; Burgess, A.P.; Gazzard, B.G.

In: AIDS Care, Vol. 13, No. 6, 12.2001, p. 709-720.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Walsh, J.C.

AU - Horne, R.

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AB - The objective of the study was to define common reasons for non-adherence (NA) to highly active antiretroviral therapy (HAART) and the number of reasons reported by non-adherent individuals. A confidential questionnaire was administered to HIV-seropositive patients taking proteinase inhibitor based HAART. Median self-reported adherence was 95% (n = 178, range = 60-100%). The most frequent reasons for at least 'sometimes' missing a dose were eating a meal at the wrong time (38.2%), oversleeping (36.3%), forgetting (35.0%) and being in a social situation (30.5%). The mean number of reasons occurring at least 'sometimes' was 3.2; 20% of patients gave six or more reasons; those reporting the lowest adherence reported a significantly greater numbers of reasons („ = - 0.59; p < 0.001). Three factors were derived from the data by principal component analysis reflecting 'negative experiences of HAART', 'having a low priority for taking medication' and 'unintentionally missing doses', accounting for 53.8% of the variance. On multivariate analysis only the latter two factors were significantly related to NA (odds ratios 0.845 and 0.849, respectively). There was a wide spectrum of reasons for NA in our population. The number of reasons in an individual increased as adherence became less. A variety of modalities individualized for each patient are required to support patients with the lowest adherence.

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Walsh JC, Horne R, Dalton M, Burgess AP, Gazzard BG. Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. AIDS Care. 2001 Dec;13(6):709-720.