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Differences in adherence and motivation to HIV therapy: Two independent assessments in 1998 and 2002
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
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2006 (English)In: Pharmacy World & Science, ISSN 0928-1231, E-ISSN 1573-739X, Vol. 28, no 4, 248-256 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to compare the level of adherence and motivation in two independent cross-sectional samples of HIV-infected patients conducted in 1998 and 2002, and to investigate the relationship between adherence and motivation. Method: Consecutive HIV-infected patients on treatment at a Swedish clinic were asked to complete an anonymous questionnaire. In 1998, 60 patients participated and in 2002, 53 participated. In 2002, the 9-item Morisky Medication Adherence Scale (MMAS) was added to the questionnaire set. Main outcome measure: Self-reported adherence and motivation. Results: In 1998, 28.1% of the respondents were considered adherent, while the corresponding proportion was 57.4% in 2002 (P = 0.002). The mean summary score for MMAS was 10.7 in 2002 (13 = perfect adherence). The proportion considered motivated were 22.4% in the 1998 survey and 41.3% in 2002 (P = 0.038). Of the respondents considered motivated in the 2002 survey, 46.7% scored the maximum summary score on the MMAS, while 8.7% of the non-motivated respondents did so (P = 0.016). Conclusion: The respondents in 2002 were more adherent and motivated than the respondents in 1998 and a relationship between motivation and adherence was found. The difference in adherence and motivation might be due to a new treatment model at the clinic.

Place, publisher, year, edition, pages
2006. Vol. 28, no 4, 248-256 p.
Keyword [en]
Acquired immunodeficiency syndrome, AIDS, Highly active antiretroviral therapy, HIV, MMAS, Patient adherence, Patient compliance, Patient motivation, Pharmacotherapy, Sweden
National Category
Pharmaceutical Sciences
URN: urn:nbn:se:uu:diva-95138DOI: 10.1007/s11096-006-9036-4ISI: 000241727000010PubMedID: 17066240OAI: oai:DiVA.org:uu-95138DiVA: diva2:169233
Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2013-01-17Bibliographically approved
In thesis
1. Adherence and Readiness to Antiretroviral Treatment
Open this publication in new window or tab >>Adherence and Readiness to Antiretroviral Treatment
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 82 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 43
Community pharmacy services, Adherence, Readiness, HIV, Pharmacy, Samhällsfarmaci
urn:nbn:se:uu:diva-7282 (URN)91-554-6719-9 (ISBN)
Public defence
2006-12-06, B41, Uppsala Biomedicinska Centrum, Husargatan 3, Uppsala, 09:15
Available from: 2006-11-14 Created: 2006-11-14Bibliographically approved

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