R Gross1, Y Zhang, R Grossberg. 1. Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. rgross@cceb.med.upenn.edu
Abstract
PURPOSE: Strict adherence to antiretroviral therapy is instrumental in viral suppression and treatment success. The relation between pharmacy-based factors and treatment adherence has been under-explored. We aimed to determine whether different medication refill mechanisms were associated with differences in antiretroviral refill adherence. METHODS: We conducted a retrospective cohort study of 110 HIV-infected subjects on standard antiretroviral regimens for >or=3 months cared for at the Philadelphia Veterans' Affairs Medical Center HIV clinic. The primary outcome was a pharmacy-based measure of antiretroviral refill adherence over the 3 months of treatment immediately prior to the study date. RESULTS: The group obtaining refills at the pharmacy had lower adherence [80% (interquartile range (IQR), 69-99%)] than the group obtaining refills via pill organizers dispensed by a pharmacist [99% (IQR, 97-100%), p=0.003] and the group obtaining refills via mail order [91% (IQR, 79-100%); p=0.04]. CONCLUSIONS: Mail ordering and pharmacists dispensing refills in pill organizers may each be effective strategies for improving medication adherence, although they target different barriers and differ in their degree of intensity. Each should be considered for adherence interventions in HIV and further studied in other disease and treatment settings. Copyright (c) 2005 John Wiley & Sons, Ltd.
PURPOSE: Strict adherence to antiretroviral therapy is instrumental in viral suppression and treatment success. The relation between pharmacy-based factors and treatment adherence has been under-explored. We aimed to determine whether different medication refill mechanisms were associated with differences in antiretroviral refill adherence. METHODS: We conducted a retrospective cohort study of 110 HIV-infected subjects on standard antiretroviral regimens for >or=3 months cared for at the Philadelphia Veterans' Affairs Medical Center HIV clinic. The primary outcome was a pharmacy-based measure of antiretroviral refill adherence over the 3 months of treatment immediately prior to the study date. RESULTS: The group obtaining refills at the pharmacy had lower adherence [80% (interquartile range (IQR), 69-99%)] than the group obtaining refills via pill organizers dispensed by a pharmacist [99% (IQR, 97-100%), p=0.003] and the group obtaining refills via mail order [91% (IQR, 79-100%); p=0.04]. CONCLUSIONS: Mail ordering and pharmacists dispensing refills in pill organizers may each be effective strategies for improving medication adherence, although they target different barriers and differ in their degree of intensity. Each should be considered for adherence interventions in HIV and further studied in other disease and treatment settings. Copyright (c) 2005 John Wiley & Sons, Ltd.
Authors: Kara M Bensley; John Fortney; Gary Chan; Julia C Dombrowski; India Ornelas; Anna D Rubinsky; Gwen T Lapham; Joseph E Glass; Emily C Williams Journal: J Rural Health Date: 2019-01-31 Impact factor: 4.333
Authors: M R Jordan; H La; H D Nguyen; H Sheehan; T T M Lien; D V Duong; J Hellinger; C Wanke; A M Tang Journal: Int J STD AIDS Date: 2009-06 Impact factor: 1.359
Authors: William H Shrank; Margaret Stedman; Susan L Ettner; Dee DeLapp; June Dirstine; M Alan Brookhart; Michael A Fischer; Jerry Avorn; Steven M Asch Journal: J Gen Intern Med Date: 2007-07-24 Impact factor: 5.128
Authors: Kara M Bensley; Kathleen A McGinnis; John Fortney; K C Gary Chan; Julia C Dombrowski; India Ornelas; E Jennifer Edelman; Joseph L Goulet; Derek D Satre; Amy C Justice; David A Fiellin; Emily C Williams Journal: J Rural Health Date: 2018-10-19 Impact factor: 4.333