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

who had previously taken and failed antiretroviral regimens were only half as likely to be in the better adherence categories and have virologic suppression than those new to therapy, they were equally likely to benefit from the MAPS intervention. Gross notes that for every 25 percent increase in antiretroviral drug doses taken, a patient's chance of having treatment success was doubled in the study.

Patients whose viral loads are suppressed are at much less risk of transmitting HIV to others in the community, so efforts to improve adherence stand to benefit the population at large.

"Importantly, we found that this intervention was equally effective for both patients who were just beginning therapy and those who had already been taking the drugs and had problems adhering, and it continued to be effective over time, unlike many approaches in which patients eventually fall into less adherent behavior," Gross says. "The effect we found also persisted even though the population we studied has many life challenges, including poverty and unemployment."

He and his colleagues suggest that the same approach could be utilized to improve treatment adherence for patients with Hepatitis C, heart failure, and other diseases, particularly if the MAPS process could be scaled back to require less interaction with interventionist, and if patients who may require "booster" sessions could be identified. The authors have made their Managed Problem Solving treatment manual available online for use by other clinicians, at http://www.med.upenn.edu/cceb/maps-form.shtml.


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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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