Effects of pill burden on discontinuation of the initial HAART regimen in minority female patients prescribed 1 pill/day versus any other pill burden
| Autor: | Jan Kavookjian, Seth Hill, John Vandewaa, Jingjing Qian, Allison M. Chung |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Pediatrics Health (social science) Social Psychology Anti-HIV Agents Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Drug Prescriptions Antiretroviral Therapy Highly Active Chart review Female patient Odds Ratio Humans Medicine Minority Groups Proportional Hazards Models business.industry Proportional hazards model Public Health Environmental and Occupational Health virus diseases Viral Load CD4 Lymphocyte Count Discontinuation Regimen Pill Polypharmacy Physical therapy Patient Compliance Drug Therapy Combination Female business Viral load |
| Zdroj: | AIDS Care. 26:595-601 |
| ISSN: | 1360-0451 0954-0121 |
| Popis: | Highly active antiretroviral therapy (HAART) is a mainstay of treatment for patients with Human Immunodeficiency Virus (HIV). Since second line HAART therapies can be costlier and less effective, it is essential to understand the duration of initial HAART therapies. The overall aim of this study was to estimate the effects of daily pill burden on the time to discontinuation of the initial HAART regimen. Patients were initially identified through the clinic's CAREWARE database. A chart review was conducted for data collection, where only adult, female, HIV-positive patients initiating therapy at the study clinic between 1 January 2001 and 31 December 2011 were included. All study subjects were followed up from the initiation of HAART to treatment discontinuation. A Kaplan-Meier curve was generated to describe time to discontinuation by regimens, and a Cox proportional hazards model was developed to assess the impact of different regimen and patient demographic characteristics on the hazard of discontinuation of the initial regimen. A total of 498 charts were initially reviewed. After assessment of these patients for inclusion criteria, a cohort of 115 adult female patients who initiated HAART at the study clinic was included. Patients treated with 1 pill/day regimen had a significantly longer time to discontinuation than regimens of1 pills/day (mean duration of initial therapy was 1062.56 days vs. 631.70 days, respectively, p = 0.003). Compared to 1 pill/day regimens,1 pills/day regimens were associated with a higher hazard of discontinuation (hazard ratio (HR) =3.44 with 95% confidence interval (CI) = 1.25, 9.48). A higher viral load and patients without insurance were also found to be significantly associated with increased hazards of discontinuation. Overall, female HIV patients initiating therapy with the 1 pill/day HAART regimen were less likely to discontinue their treatment compared to patients initiating with1 pills/day HAART regimen. |
| Databáze: | OpenAIRE |
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