Effect of Individual Cognitive Behaviour Intervention on Adherence to Antiretroviral Therapy: Prospective Randomized Trial
| Autor: | Simone Tschopp, Joachim Schmitt, Hansjoerg Znoj, Bruno Ledergerber, Lisanne Christen, Milos Opravil, Stephan Christen, Huldrych F. Günthard, Christine Schneider, Rainer Weber |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Randomization Anti-HIV Agents HIV Infections law.invention Cognition Randomized controlled trial Acquired immunodeficiency syndrome (AIDS) law Surveys and Questionnaires Internal medicine Intervention (counseling) medicine Humans Pharmacology (medical) Prospective Studies Prospective cohort study Aged Pharmacology business.industry Middle Aged Viral Load medicine.disease Psychotherapy Clinical trial Infectious Diseases HIV-1 Physical therapy Educational Status Patient Compliance RNA Viral Female Drug Monitoring business Viral load |
| Zdroj: | Antiviral Therapy. 9:85-95 |
| ISSN: | 2040-2058 1359-6535 |
| DOI: | 10.1177/135965350400900111 |
| Popis: | Objective A high level of adherence to antiretroviral therapy is required for complete suppression of HIV replication, immunological and clinical effectiveness. We investigated whether cognitive behaviour therapy can improve medication adherence. Design Prospective randomized 1-year trial. Setting Collaboration of HIV university outpatient clinic and psychotherapists in private practice. Participants 60 HIV-infected persons on stable anti-retroviral combination therapy and viral load below 50 copies/ml. Intervention Cognitive behaviour intervention in individual patients, in addition to standard of care. Main outcome measures Feasibility and acceptance of intervention; adherence to therapy assessed using medication event monitoring system (MEMS) and self-report questionnaire; virological failure; psychosocial measures. Results The median number of sessions for cognitive behaviour intervention per patient during the 1-year trial was 11 (range 2–25). At months 10–12, mean adherence to therapy as assessed using MEMS was 92.8% in the intervention and 88.9% in the control group ( P=0.2); the proportion of patients with adherence ≥95% was 70 and 50.0% ( P=0.014), respectively. While there was no significant deterioration of adherence during the study in the intervention arm, adherence decreased by 8.7% per year ( P=0.006) in the control arm. No differences between the intervention group and standard of care group were found regarding virological outcome. Compared with the control group, participants in the intervention group perceived a significant improvement of their mental health during the study period. Conclusions Cognitive behavioural support in addition to standard of care of HIV-infected persons is feasible in routine practice, and can improve medication adherence and mental health. |
| Databáze: | OpenAIRE |
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