uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Adherence to treatment in Swedish HIV infected patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Show others and affiliations
2006 (English)In: Journal of Clinical Pharmacy and Therapeutics, ISSN 0269-4727, E-ISSN 1365-2710, Vol. 31, no 6, 605-616 p.Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
2006. Vol. 31, no 6, 605-616 p.
Keyword [en]
acquired immunodeficiency syndrome, highly active antiretroviral therapy, human immunodeficiency virus, patient compliance, Sweden
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-95139DOI: 10.1111/j.1365-2710.2006.00782.xISI: 000242232900010PubMedID: 17176366OAI: oai:DiVA.org:uu-95139DiVA: diva2:169234
Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2011-05-11Bibliographically 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

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Tully, MaryKettis Lindblad, Åsa
By organisation
Department of PharmacyStatistics
In the same journal
Journal of Clinical Pharmacy and Therapeutics
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 286 hits
ReferencesLink to record
Permanent link

Direct link