[705] ADHERENCE TO ANTIRETROVIRAL THERAPY IN SENEGAL: ASSESSMENT AT THE PHARMACY LEVEL

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] ADHERENCE TO ANTIRETROVIRAL THERAPY IN SENEGAL: ASSESSMENT AT THE PHARMACY LEVEL

[AUTHOR(S):] K Diop¹, I Lanièce², K Sow³, M Ciss⁴, A Desclaux⁵, B Ndiaye¹ and I Ndoye⁶
¹Pharmacie Centrale du CHU de Fann, Dakar, Senegal; ²Coopération Française/Programme Multisectoriel de Lutte Contre le Sida, Dakar, Senegal; ³Division de Lutte contre le Sida, Ministère de la Santé, Dakar, Senegal; ⁴Laboratoire National de Contrôle des Médicaments, Dakar, Senegal; ⁵Laboratoire d’Ecologie Humaine et d’Anthropologie, University of Aix- Marseille 3, Aix-en-Provence, France; and ⁶Programme Multisectoriel de Lutte contre le Sida, Dakar, Senegal

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 705
Antiviral Therapy 2003; 8(Suppl. 1):S379

[ABSTRACT:] Access to antiretroviral therapy (ART) has been provided in Senegal to almost 900 patients through a governmental Initiative launched in 1998. At Fann hospital pharmacy in Dakar, a pilot research project started in November 1999 to assess adherence and causes of ART interruptions among a prospective observational cohort. Adherence level was estimated by the dispensing pharmacist, at each dispensation (most often each month), over the last 30 days, on the basis of patients’ stated consumption and on the proportion of the prescribed dose returned unused. 167 adult patients met the eligibility criteria and results concern 158 patients (94%). Of them, 17 (10.7%) died and 3 (1.8%) withdrew over the three-year period of observation (November 1999–October 2002). This period corresponded to 4451 patients-months of observation and adherence data were collected for 3583 patients-months (80.4%). The intent to treat antiretroviral combinations included: dual therapies (4%), three-drug therapies containing a protease inhibitor (43%) or a non nucleoside inhibitor (51%) of reverse transcriptase. Monthly cost of treatment for patients ranged from 0114 euros. The stated adherence level was high over the 36-month period: 92.3% (interquartile range: 97–100%) and reached 95% or more during 82.3% of the documented months. Preliminary results over 3 years of follow-up suggested that high observance may be sustained over time in a limited resources setting. They support that the financial burden of treatment and regimen containing a protease inhibitor (indinavir) may weaken adherence in this African urban context.

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