Standard Care Impact on Effects of Highly Active Antiretroviral Therapy Adherence Interventions

Abstract

Background: Poor adherence to medication limits the effectiveness of treatment for human immunodeficiency virus. Systematic reviews can identify practical and effec- tive interventions. Meta-analyses that control for variabil- ity in standard care provided to control groups may pro- duce more accurate estimates of intervention effects. Methods: To examine whether viral load and adher- ence success rates could be accurately explained by the active content of highly active antiretroviral therapy (HAART) adherence interventions when controlling for variability in care delivered to controls, databases were searched for randomized controlled trials ofHAARTad- herence interventions published from 1996 to January 2009. A total of 1342 records were retrieved, and 52 ar- ticles were examined in detail. Directly observed therapy and interventions targeting specific patient groups (ie, psychiatric or addicted patients, patients18 years) were excluded, yielding a final sample of 31 trials. Two cod- ers independently retrieved study details. Authors were contacted to complete missing data