242710 Efficacy of Antiretroviral Therapy Adherence Interventions

Wednesday, November 2, 2011

Jia Pu, MA , School of Pharmacy, University of Wisconsin, Madison, Madison, WI
Betty Chewning, PhD , University of Wisconsin-Madison, Madison, WI
William Hoyt, PhD , School of Education, University of Wisconsin, Madison, Madison, WI
Background: Nonadherence is one of the main barriers to achieve optimal treatment outcomes in HIV patients. This meta-analysis of antiretroviral therapy (ART) adherence intervention studies aims to better understand the efficacy of current ART adherence interventions. Methods: Medline and PsychINFO databases were searched for randomized controlled trials of ART adherence interventions between 2007 and 2010. A total of six studies were identified and included in this meta-analysis based on the inclusion criteria. Two coders independently coded each study. Both random-effects and fixed-effects analyses were used in this study. Results: Data from 957 participants were retrieved. ART adherence interventions were effective in supporting better adherence behavior in HIV patients (OR=2.27). Self-reported adherence was significantly higher than adherence measured by medication event monitoring systems (MEMS) and viral load records. Moderator analyses indicated intervention effectiveness increased with the number of intervention sessions, and decreased with the proportion of minority patients in the study sample. Previous exposure to ART did not make any difference in intervention effectiveness. Intervention intensity as measured by a behavior change technique taxonomy didn't explain intervention effectiveness. Conclusions: The findings suggest that adherence interventions do improve HIV patients' adherence to ART and their treatment outcome. Both the number of intervention sessions and proportion of minority patients in the study are important predictors for intervention effectiveness. Future studies should include adherence estimates other than self-reported data. Moreover, further investigations are needed to understand why ART interventions appear to be less effective for minority patients.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Evaluate the efficacy of current ART adherence interventions

Keywords: Adherence, Antiretroviral Combination Therapy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have received research training through my degree, also I worked for China CDC and Nebraska State government DHHS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.