Tolerability affects adherence [DHHS Guidelines]
Adverse events (AEs) are among the most common reasons for non-adherence.
- Fear of or the experience of side effects of HAART, including metabolic and morphologic side effects can also cause inadequate adherence
- Patients may have to switch or discontinue therapy due to AEs
Some of the patient factors associated with the risk of decreased adherence include:
- Active substance abuse
- Depression
- Lack of social support
Assessing adherence
A patient's estimate of suboptimal adherence is a strong predictor and should be taken seriously. Patient self-reporting of complete adherence and the clinician's estimate of the patient's likelihood of adherence are unreliable predictors.
Early detection and prompt intervention for non-adherence can greatly reduce the risk of negative consequences.
Strategies to improve adherence
DHHS Guidelines recommend strategies to improve adherence
- Establish readiness to start therapy
- Provide education on medication dosing
- Review potential side effects
- Anticipate and treat side effects
- Utilize educational aids, including pictures, pillboxes, and calendars
- Engage family and friends
- Simplify regimens, dosing, and food requirements
- Utilize team approach with nurses, pharmacists, and peer counselors
- Provide accessible, trusting healthcare team
You can make a difference in adherence
- Talk with your patients
- Greater communication between patient and healthcare provider is associated with greater adherence to treatment
- Screen for depression
- Depression is associated with nonadherence to ARV medications
- Talk to your patients about side effects of drugs
Please consult Full Prescribing Information, including boxed WARNING, Medication Guide, and Important Safety Information for VIRAMUNE.
