Number of daily pills, dosing schedule, self-reported adherence and health status in 2010: A large cross-sectional study of HIV-infected patients on antiretroviral therapy

Abstract

Objectives: The aim of the study was to assess whether pill burden is associated with self-reported adherence to current combination antiretroviral regimens and health status in a large sample of unselected and chronically treated HIV-infected patients. Methods: An adherence and health status questionnaire was offered to all patients collecting their drugs between March and May 2010 at our clinic; both parameters were primarily evaluated using a visual analogue scale. Linear correlations were evaluated using Spearman's correlation coefficient. Wilcoxon's rank-sum test and the χ2 test were used to compare quantitative and qualitative variables. The generalized linear model was used in multivariable analyses. Results: Among 2763 subjects on treatment during the study period, 2114 (78.8% male; mean age 46.9±8.84 years) were tested for adherence; 1803 (85.3%) had viral loads <50 HIV-1 RNA copies/mL. After adjusting for age, gender, HIV risk factor, current CD4 count, pill burden and dosing interval, adherence was higher in patients with undetectable HIV RNA (P<0.0001) and directly associated with current CD4 count (P=0.029). After adjusting for the same variables, health status was better in patients with undetectable viraemia (P=0.004) and in men who have sex with men (MSM) and heterosexuals compared with injecting drug users and those with other risk factors (P<0.0001 for MSM and P=0.008 for heterosexuals); it was also directly associated with current CD4 count (P<0.0001) and inversely associated with age (P<0.0001) and pill burden (P=0.019). Conclusions: In this highly adherent population, the number of daily pills was related to self-reported health status but not to self-reported adherence, whereas the dosing interval did not influence self-reported adherence or health status. © 2012 British HIV Association.