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Adherence to treatment in Swedish HIV infected patients
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
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2006 (Engelska)Ingår i: Journal of Clinical Pharmacy and Therapeutics, ISSN 0269-4727, E-ISSN 1365-2710, Vol. 31, nr 6, s. 605-616Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: The objectives were to assess the prevalence of adherence to antiretroviral treatment in Swedish human immunodeficiency virus (HIV)-infected patients and to evaluate factors associated with adherence.

Methods: All HIV-treated patients, who attended one of 30 (of a total of 32) Swedish infectious diseases clinics, during 7 months, were asked to complete an anonymous questionnaire containing the 9-item Morisky Medication Adherence Scale (MMAS) and questions about other factors potentially affecting adherence. The summary score of MMAS ranges from 1 to 13, where 13 indicates perfect adherence; patients scoring 11 or above (corresponding to 95% adherence level) were classified as 'adherent'.

Results and discussion: In total 946 patients participated (response rate 97.5%). The proportion of patients who reported not missing a dose during the day prior to the completion of the questionnaire was 97% and the proportion classified as 'adherent' was 63%. 'Adherent' patients were more likely to have a good relationship with their health care professionals (P < 0.05) and not have problems with drugs or alcohol (P < 0.01). Being older (P < 0.01) and having a shorter time on current treatment (P < 0.01) and on treatment in total (P < 0.05) were factors also associated with good adherence.

Conclusion: Factors modifiable for interventions by health care professionals are patient-provider relationship, drug or alcohol problems and patients with long treatment periods.

Ort, förlag, år, upplaga, sidor
2006. Vol. 31, nr 6, s. 605-616
Nyckelord [en]
acquired immunodeficiency syndrome, highly active antiretroviral therapy, human immunodeficiency virus, patient compliance, Sweden
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:uu:diva-95139DOI: 10.1111/j.1365-2710.2006.00782.xISI: 000242232900010PubMedID: 17176366OAI: oai:DiVA.org:uu-95139DiVA, id: diva2:169234
Tillgänglig från: 2006-11-14 Skapad: 2006-11-14 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
Ingår i avhandling
1. Adherence and Readiness to Antiretroviral Treatment
Öppna denna publikation i ny flik eller fönster >>Adherence and Readiness to Antiretroviral Treatment
2006 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Antiretroviral therapy places extraordinarily high demands on adherence, since non-adherence affects both individuals and society due to the spread of resistant viral strains. The aims of the thesis were to investigate the prevalence of adherence in Swedish HIV-infected patients, changes in adherence over time, and factors associated with adherence, including patients’ readiness to adhere. Further, to investigate the collaboration between nurses, doctors and pharmacists after the introduction of a HIV-clinic satellite pharmacy. Data were collected via two cross-sectional patient surveys in 1998 and 2002, qualitative interviews with health care personnel at a major HIV clinic, and a nation-wide, cross-sectional patient survey in 2003-2004.

The level of adherence improved from 28% in 1998 to 57% in 2002, possibly due to simplified treatment and a new multi-professional treatment model at the clinic. The proportion of adherent patients was 63% in the nationwide survey. Factors associated with adherence were high age, high quality patient-provider relationships, no drug or alcohol problems and shorter time on treatment.

A hypothesized structural equational model, using readiness and adherence as separate latent concepts, was tested and found to support readiness as a distinct factor influencing adherence.

The health care personnel believed that conventional pharmacies had several disadvantages in serving the HIV infected population. They found the HIV-clinic satellite pharmacy valuable, since it contributed to increased communication and trust between the health care professions, and improved teamwork in medication management.

In conclusion, the level of adherence increased over time, and several factors associated with adherence were identified. Improved collaboration between health care professionals may enhance treatment support, and increased attention should be given to interventions that focus on the individual’s readiness for behavioural change in order to optimize treatment outcomes.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2006. s. 82
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 43
Nyckelord
Community pharmacy services, Adherence, Readiness, HIV, Pharmacy, Samhällsfarmaci
Identifikatorer
urn:nbn:se:uu:diva-7282 (URN)91-554-6719-9 (ISBN)
Disputation
2006-12-06, B41, Uppsala Biomedicinska Centrum, Husargatan 3, Uppsala, 09:15
Opponent
Handledare
Tillgänglig från: 2006-11-14 Skapad: 2006-11-14Bibliografiskt granskad

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