[759] BASELINE DATA AND PREDICTORS OF ADHERENCE TO ANTIRETROVIRAL THERAPY IN MAUN GENERAL HOSPITAL (MGH), MAUN, BOTSWANA

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] BASELINE DATA AND PREDICTORS OF ADHERENCE TO ANTIRETROVIRAL THERAPY IN MAUN GENERAL HOSPITAL (MGH), MAUN, BOTSWANA

[AUTHOR(S):] JI Nwokike
Maun General Hospital, Maun, Rep. of Botswana

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 759
Antiviral Therapy 2003; 8(Suppl. 1):S396

[ABSTRACT:] Background: In Botswana, there is a lack of baseline data to determine the level of adherence to antiretroviral drugs. This study, an institution based, quantitative and retrospective study had an objective to determine baseline adherence values and identify the predictors of adherence amongst treatment experienced patients.

Method: The study involved 176, 3 months treatment-experienced patients on antiretroviral drugs at MGH; one of the project sites of the Botswana National Antiretroviral Program. Patient files were randomly selected. These files were analysed for adherence reports. The adherence measurement instruments used were the 7 days recall self-complete questionnaire and pill counts. Pills identification tests, structured interviews and monthly pill calendar counterbalanced the vulnerability of these methods to fabrications. The study had a zero tolerance to nonadherence. In the follow-up study 182 randomized 3 months experienced patients were administered self-complete questionnaires.

Results: From the 176 patients reviewed, there was a determined average adherence per month value of 24.948 days (83.16%). Most Patients were on Combivir/efavirenz combination (54.39%); this patient group had 24.99 adherent days/month (upper 95% confidence interval of 25.72). Combivir/nevirapine combination was 29.82% (95% confidence interval of 26.37, P-value for the two groups ≥0.10) Adherence promoters were found to be: adherence partners, 51 patients out of 182 (28.02%); pharmacy counselling, 48 or 26.37%; and pill count at 32 (17.58%). Nonadherence predictors include: forgot, 49 patients (26.92%); access, 37 (20.33%); and lack of privacy, 33 (18.13%).

Conclusions: Adherence to antiretroviral drugs at the MGH is below the threshold of 95% that guarantees viral suppression. The identified predictors of adherence can be used to develop interventions to improve adherence on these patients.

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