3027.0: Monday, November 13, 2000 - Board 5

Abstract #12552

Developing and maintaining adherence: Mastering the challenges

Eunice S. King, PhD, RN, School of Nursing, MCP Hahnemann University, 1505 Race Street, Mail Stop 501, Philadelphia, PA 19102-1192, 215-762-4636, Eunice.King@Drexel.edu and Linda Dean, MSN, CRNP, HIV AIDS Medicine Section, Partnership Comprehensive Care Practice, MCP Hahnemann University, 1427 Vine Street--5th Floor, Philadelphia, PA 19102-1192.

This qualitative, descriptive study sought to describe patients’ perceptions of facilitators and barriers to HIV medication adherence since initiating treatment and to elicit recommendations for improving adherence for themselves and others. Two focus groups and 14 in-depth interviews were conducted and audio-taped, then transcribed, verified, and independently coded for content and themes by two coders. Participants were predominantly African American men and women, ranging in age from 30 -51, with half reporting monthly incomes of less than $500. The major theme emerging from this analysis was that adherence is a process. It begins with acceptance of the HIV diagnosis and committing to a medication regimen, but is dependent upon the development of instrumental strategies to foster the medication-taking habit and finding motivational facilitators for maintaining the commitment. In addition, for most participants, maintaining adherence requires on-going monitoring and active employment of strategies for surmounting potential barriers, such as changes in daily routines, medication side effects, renewed doubts about the medication's efficacy, ‘medication fatigue,’ and depression. Even among this highly committed sample, 11 reported missing at least one dose of their medication the day prior to the interview, six reported missing at least one dose the day before that, and many reported taking their medication "off-schedule." Receiving support from others, having a positive relationship with one's provider, developing new strategies to minimize forgetting, adopting a positive attitude towards one's illness, and believing in the medication's efficacy were seen as important facilitators of adherence, both for oneself and others.

Learning Objectives: After this presentation, the participant will be able to (1) Describe the components of the adherence process, (2) List 5 instrumental strategies used to develop a medication-taking habit; (3)Identify 3 motivational facilitators for maintaining a committment to adherence; and (4) Describe 3 on-going challenges to maintaining adherence

Keywords: Adherence, HIV/AIDS

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA