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APHA Scientific Session and Event Listing

Recorded presentation

Elizabeth A. Sommers, MPH, LicAc, Research Dept., Pathways to Wellness, 142 Berkeley St. - 2nd floor, Boston, MA 02116, (617)859-3036 ext. 24, esommers@bu.edu

Background: Cost-effectiveness of a variety of interventions to improve adherence to antiretroviral therapy (ART) has been extensively explored in the literature; these interventions include directly observed therapy, automatic drug dispensers, beepers, and monitors with alarms. The literature contains few resources, however, on interventions that use a physiological approach to promoting adherence. In the case of acupuncture, the physiological perspective is addressed through managing undesirable and uncomfortable digestive side effects. The prevalence of digestive side effects has been reported to be a major contributor to inadequate adherence. This presentation will address aspects of adherence related to the control of medication side effects in the context of cost-effectiveness analysis. Methods: Using data collected between 1/1/02 and 2/28/05 at the AIDS Care Project (ACP), a non-profit public health acupuncture clinic in Boston, estimates of cost and effectiveness of acupuncture treatment were determined. Data were collected at 6-month intervals on CD4 counts, viral load levels, and adherence. These data, obtained in the context of observational assessments, were used to assess cost-effectiveness of acupuncture treatment, and compared with data from published literature on other cost-effectiveness interventions. Results: Records of 423 individuals beginning acupuncture treatment were identified; approximately 300 of these records contain complete information about individuals using HIV-medications at intake. The analysis is ongoing and will be completed in March, 2006. It is anticipated that cost-effectiveness will vary according to level of illness. The analysis may serve to identify which sub-populations of people with HIV/AIDS may benefit most from acupuncture treatment.

Learning Objectives: The presentation will

• Acquaint attendees with at least 2 theories about how acupuncture influences medication adherence
• Promote understanding of why a range of options are necessary to promote adherence to HIV-medications
• Increase attendees' ability to recognize the value of using a cost-effectiness framework in determining the value of an intervention

Keywords: Adherence, Economic Analysis

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation