BACKGROUND: Interventions to improve ART adherence are critical to effective treatment of HIV. Enhanced patient participation in medical decision-making has improved health outcomes linked to adherence in other chronic illnesses. Purpose: To develop and assess an intervention to improve patients' participation in medical decision-making around ART adherence. METHODS: We used data from prior studies to develop a conceptual model of the determinants of ART adherence. Based on this model, we designed a patient audiotape and workbook to improve adherence to ART. These tools use patient characters to model patient empowerment, inform patients about ART and teach medication-taking skills. The audiotape/workbook tool was pilot-tested in three iterative phases. First, we assessed its face validity and theoretical integrity among clinicians and social scientists. Second, we administered the intervention to 20 HIV+ patients. Third, based on patient feedback, we revised the tape/workbook intervention and administered it to a second group of 20 HIV+ patients. RESULTS: Mean age of the 40 patients was 40 with: 80% African-American; 40% having < a high school degree; 70% making < $10K/yr. Ninety-five percent felt the intervention was very helpful and enjoyable. In group one: 80% felt more confident in their ability to take their ART; 80% felt more likely to follow their prescriptions exactly; and 75% intended to begin use of a medication calendar. In both groups, about 50% said they were likely to ask their doctor more questions. CONCLUSION: We have developed a useful, acceptable audiotape-based tool to improve adherence to ART by enhancing patient participation.
Learning Objectives: At the conclusion of this session, the participant will: 1)be able to recognize an audiotape-based behavioral tool to enhance HIV+ patients' adherence to antiretroviral therapy 2)become familiar with factors the help patients with HIV adhere with complex antiretroviral regimens. 3)recognize a conceptual model of determinants of adherence to antiretroviral therapy
Keywords: HIV/AIDS, Adherence
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.