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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
M. Jane Mohler, RN, MPH, PhD1, Carol R. Baldwin, RN, PhD2, and Kendall Kroesen, PhD1. (1) Health Services Research Center, Southern Arizona VA Health Care System, 3601 S. 6th Avenue, 0-151, Tucson, AZ 85723, 520-629-1824, mohlerconsulting@theriver.com, (2) College of Medicine, University of Arizona, AHSC, Respiratory Sciences, 2501 N. Campbell, PO245030, Tucson, AZ 85724
Objective: Although poor-adherence is not the sole cause of HAART (highly active antiretroviral treatment) treatment failure, it is often the only remediable factor. We sought to learn about effective adherence-support behaviors, attitudes and skills, as well as barriers and enablers of HAART adherence in patients living with HIV. Design: A qualitative inquiry was performed using sub-samples from the highest and the lowest tertiles of adherence based upon medication event monitoring data from a descriptive study. Methods: A high-adherer focus group was held using patients within the highest tertile of adherence. Content analysis was used to develop an inductive framework of -successful-adherence using focus group data. Individual interviews were then used to deconstruct associations, perceived management strategies, and barriers to adherence in subjects within the lowest tertile. Content analysis explored the patterns, themes and barriers associated with poor adherence; constant comparative analysis compared and contrasted the successful-adherence framework with low-adherer findings for framework validation. Results: Content analysis indicated six adherence-enhancing factors: 1) adherence self-efficacy, 2) perceived treatment efficacy, 3) knowledge of regimen, 4) social support, 5) patient adherence skills, and 6) health care considerations, and one adherence-disrupting category, 7) poorly structured daily life. Low-adherer responses matched the inverse of five of the successful-adherence categories. Two categories--“knowledge” and “health care considerations”-- were equivalent . No additional low-adherer categories were identified outside the framework, lending validity to our successful-adherence framework. Study findings both corroborate and augment those previously reported, and provide a framework to guide future antiretroviral and chronic disease adherence research.
Learning Objectives:
Keywords: HIV Interventions, Adherence
Presenting author's disclosure statement:
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.