Year: 2004
Type: conference-paper
Study design: Observational Study
Abstract: Introduction: Adherence is the extent to which a person's behaviour is consistent with health care recommendations [1] .Adherence to a certain therapeutic regime will determine an illness clinical outcome; indeed, treatment strategies must be sustainable to be successful [2] .But how can we quantitatively measure adherence?Some consider that good adherent patients are those who carry out about 80 % of the recommended behaviour [1] , while others believe that an adherence of 95% is the required standard [3] .Actually, adherence is a multifactorial variable depending upon determinants such as population features and the complexity of therapeutic regime [4] .However some argue that those taking more pills in a daily basis do not seem to differ in terms of compliance from the ones who take simpler regimens [5] .The fact that complex and expensive antiretroviral therapeutics are currently at use makes it important to acknowledge its efficacy which is highly correlated with adherence.Investigating the compliance to such therapies should be a priority on any clinical setting where HIV patients are followed up [6] .Various methods to measure adherence have been used such as patient-report adherence; pill count; serum concentration of antiretroviral; assisted medication taking [7] .Each one of these methods has its pros and cons, thus using them isolated seem to lack scientific value [8] .However, and despite its limitation, there is one method which is refill compliance using pharmacy records very useful in predicting patient behaviour towards their medication [9] .This latter method allows the identification of those individual who will not certainly have successful treatment duo to lack of medication acquisition [10, 11] . Objective: Assessment of HIV patient compliance to antiretroviral therapy based on Pharmacy files.Methods: This is a six-month longitudinal prospective descriptive study starting in January 2004.Our sample population consisted of HIV patients undergoing antiretroviral therapy, except pregnant women and HIV patient while in haemodialysis, who received medication from the Pharmacy Department of Hospital Fernando Fonseca during the study's first month.Hospital Fernando Fonseca is a Public General Hospital within the National Health System Hospital Network.This health unit serves a population of about 600.000 individuals and has approximately 678 inpatients beds.After a previous pilot project to certificate the quality of this study, the authors and other pharmacists collected data that were gathered in the pharmacy records for each patient.These data included demographic variables (age, race and gender) therapeutic regimens features and refill compliance features (dates of pharmacy department visits and number of pills obtained in each visit).Based on refill compliance using pharmacy records we assessed a Continuous Measure of Medication Acquisition (CMA = Cumulative days' supply obtained /Total days to next fill or end of observation period).This index will ultimately give us the adherence of our population to HIV therapy dispenses.We decided to include in our project the number of days spent in the hospital ward to increase CMA's probability to be the actual adherence to antiretroviral therapies.Data were gathered in the Microsoft Excel 2000 and analysed using the Statistical Package for Social Science 9.0 program.
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W34324474