OBJECTIVES: Antiretroviral treatment (ART) scale-up in sub-Saharan Africa has made it possible to investigate the maintenance of adherence to HIV medications. We describe here adherence to ART and identify its correlates in the Cameroonian context. DESIGN: Prospective cohort study in 9 rural district hospitals. METHODS: A mixed logistic regression model was used to identify factors associated with adherence to ART in 401 patients with data prospectively collected on adherence. RESULTS: Although 73% of patients were adherent after the first month on ART, this proportion decreased to 61% after 24 months. After adjustment for known factors of adherence to ART (such as knowledge, motivation and side-effects), patients who reported willingness to start ART before initiation, those who were satisfied with information provided by their physicians, and those who implemented reminder methods for ART intake {eg, using an alarm clock, mobile phone, or watch [odds ratio (95% confidence interval)] = 2.45 (1.58 to 3.79), but also the help of a relative to remind them or other methods} were more likely to be adherent to ART. CONCLUSIONS: Besides highlighting some correlates already known to have an impact on adherence to ART, our findings also underline the need to reinforce the counseling component of follow-up through innovative methods. Accordingly, training and implementation research should encourage the use of medication reminder methods, such as mobile phones, to assure adherence over time and improve long-term response to ART.
OBJECTIVES: Antiretroviral treatment (ART) scale-up in sub-Saharan Africa has made it possible to investigate the maintenance of adherence to HIV medications. We describe here adherence to ART and identify its correlates in the Cameroonian context. DESIGN: Prospective cohort study in 9 rural district hospitals. METHODS: A mixed logistic regression model was used to identify factors associated with adherence to ART in 401 patients with data prospectively collected on adherence. RESULTS: Although 73% of patients were adherent after the first month on ART, this proportion decreased to 61% after 24 months. After adjustment for known factors of adherence to ART (such as knowledge, motivation and side-effects), patients who reported willingness to start ART before initiation, those who were satisfied with information provided by their physicians, and those who implemented reminder methods for ART intake {eg, using an alarm clock, mobile phone, or watch [odds ratio (95% confidence interval)] = 2.45 (1.58 to 3.79), but also the help of a relative to remind them or other methods} were more likely to be adherent to ART. CONCLUSIONS: Besides highlighting some correlates already known to have an impact on adherence to ART, our findings also underline the need to reinforce the counseling component of follow-up through innovative methods. Accordingly, training and implementation research should encourage the use of medication reminder methods, such as mobile phones, to assure adherence over time and improve long-term response to ART.
Authors: Lawrence Mbuagbaw; Mia L van der Kop; Richard T Lester; Harsha Thirumurthy; Cristian Pop-Eleches; Marek Smieja; Lisa Dolovich; Edward J Mills; Lehana Thabane Journal: BMJ Open Date: 2013-05-28 Impact factor: 2.692
Authors: Lawrence Mbuagbaw; Lehana Thabane; Pierre Ongolo-Zogo; Richard T Lester; Edward J Mills; Marek Smieja; Lisa Dolovich; Charles Kouanfack Journal: PLoS One Date: 2012-12-06 Impact factor: 3.240
Authors: Lawrence Mbuagbaw; Lehana Thabane; Pierre Ongolo-Zogo; David Yondo; Stephen Noorduyn; Marek Smieja; Lisa Dolovich Journal: AIDS Res Ther Date: 2012-12-19 Impact factor: 2.250