Advertisement

Once-daily regimens were associated with a higher rate of self-chosen discontinuations

  • R Murri
  • A Cingolani
  • A De Luca
  • S Di Giambenedetto
  • G Marasca
  • A Muscatello
  • V Mazzocato
  • L Bracciale
  • E Tamburrini
Open Access
Poster presentation
  • 374 Downloads

Keywords

Health Status Status Measure Symptom Score Drug Prescription Multivariable Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Purpose of the study

In order to evaluate variables correlated to self-reported discontinuations (SRDisc) of HAART in HIV-infected people, a prospective, cohort(AdUCSC), monocenter study was conducted.

Methods

A short questionnaire on adherence (0 to 100 scale on the question "How much are you adherent to drug prescriptions?"), self-reported discontinuations, satisfaction and trust in therapy, physical (PhysH) and Mental(MentH) Health, and self-reported symptoms was administered at any visit to any outpatient taking HAART. An automatic report resuming the adherence, self-reported discontinuations and health status measures was generated and sent to physician for discussion with patient at the following visit. A SRDisc event was defined when patient reported having stopped all the drugs for at least 24 hours in the 2 months before. A composite measure for viro-immunological failure was used (CD4<200 or CD4 decreasing respect to a 1-year previous value or HIV-RNA>50 c/ml). A symptom score was built summing self-reported scores (from 0-at all to 4-very much) for each of 19 listed symptoms.

Summary of results

At May 2008, 515 patients had filled the questionnaire: 33% females, mean age 45 years (SD 8.7), IDU 20%, median of HIV 11 years (IQR 6–15); median log HIV-RNA 1.7 c/ml (IQR 1.7–1.7), median CD4 572/mm3 (IQR 414–778). 54% were taking PI, 30% NNRTI, and 13% only NRTI; <10% were previously naive to antiretrovirals. 40.6% were taking a QD regimen. Mean SelfAdher was 79.3 (SD 18.5); 19.5% reported adherence<60. 14.5% reported having missed at least one dose in the previous week. 119 (23.1%) reported having done at least one 24-hour of discontinuations in the 2 months before. Risk of viro-immunological failure was higher for people self-reporting discontinuation compared to those not (OR 1.85; 95% CI 1.15–2.98; p = 0.01). Self-reporting discontinuations were also correlated to self-reported adherence (for any point more of adherence OR 0.95; 95% CI 0.94–0.97; p < 0.001).

At multivariable analysis, even adjusted for type of HAART, variables independently correlated to self-reporting a discontinuation were: being female (OR 1.98; 95% CI 1.09–3.58; p = 0.02), IDU (OR 2.10; 95% CI 1.07–4.13; p = 0.03), taking a QD regimen (OR 1.96; 95% CI 1.10–3.48; p = 0.02), and symptom score (OR 1.02; 95% CI 1.0–1.06; p = 0.05).

Conclusion

Being female, IDU, taking a QD regimen and symptom score were correlated to self-chosen discontinuations of HAART. It is possible that people taking a QD regimen perceive therapy as a very easy task and are more prone to forgetful events.

Copyright information

© Murri et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

Authors and Affiliations

  • R Murri
    • 1
  • A Cingolani
    • 1
  • A De Luca
    • 1
  • S Di Giambenedetto
    • 1
  • G Marasca
    • 1
  • A Muscatello
    • 1
  • V Mazzocato
    • 1
  • L Bracciale
    • 1
  • E Tamburrini
    • 1
  1. 1.Institute of Infectious DiseasesCatholic UniversityRomaItaly

Personalised recommendations