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Personalized plans to address barriers to HIV drug adherence boost chances of successful therapy
Date:1/29/2013

c lifestyle can interfere, too," Gross says. "We know from previous research that these issues cannot be overcome by simple education or simple technology alone, and financial incentives typically don't produce a sustained effect."

The researchers studied 180 patients receiving care at three Philadelphia HIV clinics, who were divided into two groups, one of which was randomized to a Managed Problem Solving (MAPS) group, and the other to usual care, which included a meeting with a pharmacist for drug regimen education and the provision of pill organizers. In order to study the benefit of the intervention, only patients who had detectable viral loads were enrolled.

With the help of a trained lay interventionist, MAPS participants received education about their newly prescribed drug regimen and then were taken through a process for identifying their personal barriers to adherence, brainstorming potential solutions, selecting the best option and monitoring its implementation. Potential solutions included memory and cognitive aids to remember to take and refill the drugs, ways to use social supports, and resources to seek help for depression or drug side effects. These plans were made during four initial in-person sessions and 12 telephone meetings that provided help for solving new problems and offering encouragement for obtaining refills and maintaining their regimens. Both groups' adherence to their drug regimen was recorded through the use of an electronically monitored pill bottle.

The results showed that the MAPS group was nearly twice (1.78 times) as likely as the usual care group to be at the better end of the adherence scale. Importantly, the researchers showed that this improvement in adherence translated to improvement in a key marker of survival. The MAPS group also had a 50 percent improvement in their viral suppression rate having no detectable HIV virus in the blood while on treatment. Although the findings showed that patients
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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

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