|
13th Annual Conference of the British HIV Association29 March–1 April 2007, Brighton, UK |
THE EXPERIENCE OF TREATMENT SWITCHING
HIV Med 2007; 8(Suppl. 1):12 (abstract no. P8)
Lorraine Sherr1, Richard Harding2, Fiona Lampe1, Sally Norwood1, Margaret Johnson3, Heather Leake Date5, Martin Fisher5, Jane Anderson6, Sarah Zetler6, Gilly Arthur7 and Simon Edwards4
1Royal Free and University College Medical School, London, UK, 2Kings, London, UK, 3Royal Free, London, UK, 4Mortimer Market, London, UK, 5Royal Sussex County Hospital, Brighton, UK, 6The London/Homerton, London, UK, 7Archway, London, UK
AIM: Explore treatment switching experience for patients receiving antiretroviral treatment.
METHOD: A total of 778 consecutive HIV-positive patients attending five centres (London and the South-East) completed a cross sectional inventory to examine HIV treatment decisions, satisfaction, switching rates and triggers, stopping, treatment adherence, symptoms, quality of life, risk behaviour and doctor–patient satisfaction.
RESULTS: 77% of all patients were eligible and 86% returned completed data. 155 (20.8%) were treatment-naïve, 623 (79.2%) had taken ART – 161(21.6%) on first treatment, 135 (18.1%) one switch, 196 (26.3%) multiple switches and 99 (13.3%) had stopped treatment. Switching triggers clustered into four main trigger groups: Side effects, Difficulties with the medications, Toxicity and Resistance. The most common major reasons for switching treatment were Not keeping the amount of virus down (26.1%), Concerns about the future effect of medicine (24.1%), Body shape changes (20.4%), Issues about resistance (19.3%) and Feeling sick/nausea (18.5%). Gay males were more likely to be multiple switchers and heterosexual females were more likely to be treatment naïve. Heterosexual males were less likely to be treatment naïve, and more frequently non-switchers. Multiple switchers were more likely to be White, UK born and have lived in the UK for >5 years. Generally Treatment Naïve, Non-switchers and One-switchers reported lower symptoms and higher quality of life. Multiple Switchers reported higher physical symptom burden (P=0.003), a higher global distress (P=0.002), higher psychological symptoms (P=0.03) and a higher global distress score (P=0.002). Multiple switchers had lower quality of life (P=0.02). 63% of switchers were doctor driven, 21% patient driven.
CONCLUSION: Treatment switching is common, and multiple switching has become more prevalent. Patient experience and decision making around such switches affects satisfaction and adherence, and is related to symptom burden, which is high.
2007-03-29
P8
Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD