This meta-analysis synthesizes eighty-four observational studies, conducted across twenty countries, to determine the mean proportion of people who reported ≥90% adherence to prescribed highly active antiretroviral therapy (HAART) and to identify the factors associated with high levels of adherence. Eight electronic databases were searched to locate all relevant studies available by January 2010, which were then coded for sample characteristics and adherence levels. The average rate of reporting ≥90% adherent HAART adherence is 62%. However, this proportion varies greatly across studies. In particular, a greater proportion of individuals maintaining ≥90% adherence to HAART is more likely in studies with higher proportions of men who have sex with men (MSM) and lower proportions of injection drug users (IDU), with participants in an earlier stage of infection, and in studies conducted in countries characterized by lower Human Development Index (HDI) scores.

Adherence to Highly Active Antiretroviral Therapy (HAART): A Meta-Analysis

http://www.ceatenf.ufc.br/ceatenf_arquivos/ceatenf_arquivos/Artigos/13.Revisi%f3n%20de%20tests%20de%20medici%f3n%20del%20cumplimiento.pdf

Revisión de tests de medición del cumplimiento terapéutico utilizados en la práctica clínica

Observational studies have found that women tend to have lower adherence to highly active antiretroviral therapy (HAART) than men do, though no meta-analysis has yet investigated this trend. The aims of the current meta-analysis are to determine if and to what degree the percentage of men versus women maintaining ≥90% adherence to prescribed HAART differs, and if the external variables moderating adherence differs by gender. Eight electronic databases were searched to locate all relevant studies available by May 2011. Fifty-six observational studies were eligible for inclusion in the meta-analysis. A random effect model was assumed for the global percentage estimation and to explain the heterogeneity. Across these studies, the difference between men and women in the proportion of individuals with ≥90% adherence to HAART was marginally significant (p<0.1; 67% and 62%, respectively). A greater proportion of men maintaining ≥90% adherence to HAART was more likely in studies with higher proportions o...

Sex differences in adherence to highly active antiretroviral therapy: a meta-analysis.

Aim
To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease.

Background
Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations.

Design
Randomized controlled trial.

Methods
Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010–May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up.

Findings
When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5·3), but no statistically significant change was observed in the other two outcome measures.

Conclusion
This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease.

Resumen Objetivo Evaluar el efecto de la actuacion del farmaceutico, mediante seguimiento farmacoterapeutico (SFT) en la mejora de la adherencia y de objetivos terapeuticos. Diseno Estudio clinico experimental controlado, aleatorizado, comparativo de un programa de SFT con el proceso habitual en farmacias comunitarias espanolas mejorado con educacion sanitaria, durante 8 meses. Emplazamiento Nueve farmacias comunitarias espanolas. Participantes Pacientes entre 25-74 anos con riesgo cardiovascular (RCV) alto-moderado, que acudieron con una receta, a su nombre, de medicamentos para al menos un factor de RCV. Intervenciones Los pacientes se asignaron aleatoriamente al grupo intervencion (GI), que recibio SFT y educacion sanitaria, o al grupo control (GC), que recibio solamente educacion sanitaria. Mediciones principales Adherencia al tratamiento y cifras de presion arterial (PA) y colesterol total (CT), al inicio y final estudio. Resultados De los 87 pacientes reclutados, 85 acabaron el estudio: 41 del GC y 44 del GI. Ambos grupos aumentaron la adherencia al final del estudio [GC: 26,9%; IC95%:12,7 a 41; GI: 27,3%; IC95%:13,6 a 41]. Aunque el GI mostro mejores resultados en la variacion de las cifras de PA y CT, las diferencias en relacion al GC no fueron estadisticamente significativas. Conclusiones El SFT y la educacion sanitaria mejoran la adherencia al tratamiento. Ademas ser paciente cumplidor al final del estudio se relaciona con la mejora de los objetivos de la presion arterial y de presion arterial/colesterol total.

/pdf/efecto-de-la-actuacion-farmaceutica-en-la-adherencia-del-5eajd5lge5.pdf

Efecto de la actuación farmacéutica en la adherencia del tratamiento farmacológico de pacientes ambulatorios con riesgo cardiovascular (Estudio EMDADER-CV-INCUMPLIMIENTO)

http://www.aulamedica.es/gdcr/index.php/fh/article/download/1029/1029

E.M. Fernández-Villalba

Papers

Escala simplificada para detectar problemas de adherencia (ESPA) al tratamiento antirretroviral