Article Text
Abstract
Background and importance The goal of antiretroviral therapy (ART) is to reduce a person’s viral load to undetectable levels. Poor adherence to ART is the first cause of therapeutic failure in patients infected with HIV. Furthermore, this fact can lead to HIV drug resistant strains.
Aim and objectives The main objective of the study was to determine the degree of adherence to ART and the factors that can influence adherence.
Material and methods A retrospective, observational and descriptive study of adherence in HIV over a 12 month period was conducted. HIV patients receiving ART were included. To measure adherence, we used the following methods: HIV viral load (VL) testing, CD4 count and dispensation record of our programme. VL was considered undetectable if <20 copies/mL. Adherence data were calculated based on the units dispensed according to the days of treatment prescribed. Adherence was considered optimal when >95%. Some patients were selected for more comprehensive follow-up due to poor adherence.
Registered variables were sex, risk factors that could compromise adherence, analytical values (CD4 count, VL) and pill numbers.
Data were collected from an electronic prescription programme (Farmatools K.2.6) and the computerised medical history, MambrinoXXI.
Results During the study period, 128 patients receiving treatment were analysed: 50% were being treated with one tablet, 32% with two tablets and 18% with three or more tablets.
In 92% of patients, an undetectable VL was found. In 73%, CD4 level was >500/µmol. No relationship between VL or CD4 and adherence was found. Of the total number of patients receiving treatment, 92% were considered adherent and 8% had <95% adherence.
Risk factors that hindered adherence were a history of non-adherence (60%), lack of social support structures (50%), psychological distress (40%) and poor access to medication (30%).
Conclusion and relevance The results reflected a high adherence rate (>95%). Determination of analytical values, such as VL and CD4, and the record of dispensations of each patient, are methods for measuring adherence to ART.
It is important to monitor those patients who may have risk factors that compromise adherence. The hospital pharmacist can help to improve adherence.
References and/or acknowledgements http://www.revistadelaofil.org/adherencia-al-tratamiento-antirretroviral-en-pacientes-vih-todavia-queda-mucho-por-hacer/
http://www.revistamultidisciplinardelsida.com/wp-content/uploads/2016/03/original-6-SIDA-v1n1.pdf
https://www.sefh.es/bibliotecavirtual/2_AF_VIH_2002/8_adhesion_tratamiento.pdf
No conflict of interest.