Journal ArticleDOI
Determinants of nontraditional therapy use in patients with HIV infection. A prospective study.
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TLDR
No beneficial effect on disease progression, CD4 cell count, or mortality was observed in patients with HIV when compared with patients receiving only conventional medical therapy, and HIV care givers should be aware of its use in patients and take a history of nontraditional therapy first.Abstract:
Background: The popularity and use of nontraditional therapies among patients with human immunodeficiency virus (HIV) infection has grown enormously. Design: A prospective, longitudinal cohort study of 56 patients aged 23 through 68 years with HIV infection followed up at the HIV clinic at a university-affiliated Veterans Affairs Medical Center. Objective: To assess the demographic and psychologic characteristics of patients who seek nontraditional remedies, and their impact on disease progression and mortality from HIV. Methods: A standardized, self-administered questionnaire to assess the incidence and type of nontraditional therapies used by patients with HIV. Data on demographics, medical status, physical functioning (Karnofsky performance score), CD4 lymphocyte counts, depression (Beck Depression Inventory), coping (inventory of coping with illness scale), psychological and/or emotional stress (Profile of Mood States scores), and compliance with prescribed therapy were prospectively assessed on all patients at baseline and every 6 months. Results: Thirty percent of patients reported using nontraditional therapies. Nontraditional therapy users were significantly older than patients who did not use such therapies (44 vs 38 years,P=.03); with 94% of patients who used nontraditional therapy being older than 35 years compared with 56% of conventional therapy users (P=.005). Alternative therapy use did not correlate with race, education, HIV—risk group affiliation, duration of HIV seropositivity, stage of HIV disease, CD4 cell count, or Karnofsky performance scores. Nontraditional therapy users reported greater community-based acquired immunodeficiency syndrome group support (P=.06), greater perceived social support (P=.08), and significantly higher recreational or "street drugs" use (P=.02). Depression, adaptive coping, and emotional stress were not different between nontraditional and conventional therapy users; however, nontraditional therapy users were significantly more assertive (P=.04). On follow-up, CD4 cell count, HIV disease progression, physical functioning, or mortality were similar between the two groups. Conclusions: Recourse to nontraditional therapy is common among patients with HIV. Because of the possibility of untoward effects and potential adverse drug interactions associated with nontraditional therapy, HIV care givers should be aware of its use in their patients and take a history of nontraditional therapy use. Patients who choose nontraditional remedies do so not because they are depressed or emotionally disturbed, but rather because they seek greater control of the outcome of their disease. However, no beneficial effect on disease progression, CD4 cell count, or mortality was observed in these patients when compared with patients receiving only conventional medical therapy. (Arch Intern Med. 1996;156:197-201)read more
Citations
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Better Physician-Patient Relationships Are Associated with Higher Reported Adherence to Antiretroviral Therapy in Patients with HIV Infection
TL;DR: This study showed that multiple, mutable dimensions of the physician-patient relationship were associated with medication adherence in persons with HIV infection, suggesting that physician- patient relationship quality is a potentially important point of intervention to improve patients’ medication adherence.
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A review of the incorporation of complementary and alternative medicine by mainstream physicians.
TL;DR: It is suggested that large numbers of physicians are either referring to or practicing some of the more prominent and well-known forms of CAM and that many physicians believe that these therapies are useful or efficacious.
Journal ArticleDOI
Depression and Adherence to Antiretroviral Therapy in Low-, Middle- and High-Income Countries: A Systematic Review and Meta-Analysis
Olalekan A. Uthman,Jessica F. Magidson,Steven A. Safren,Jean B. Nachega,Jean B. Nachega,Jean B. Nachega +5 more
TL;DR: The magnitude of the association significantly decreases with more recent publications and increasing study sample size, and the likelihood of achieving good adherence to ART was lower among those with depressive symptoms compared to those without.
Journal ArticleDOI
A systematic review of beliefs involved in the use of complementary and alternative medicine.
TL;DR: The evidence surrounding the hypothesis that people might be attracted to and use complementary and alternative medicines because they hold beliefs that are congruent with CAM is collated, examines and synthesizes.
Journal ArticleDOI
Use of complementary medicine by adult patients participating in HIV/AIDS clinical trials.
Andrew Sparber,Jacqueline C. Wootton,Larry Bauer,Gregory A. Curt,David Eisenberg,Tina Levin,Seth M. Steinberg +6 more
TL;DR: Patients diagnosed with HIV/AIDS participating in clinical research protocols at the National Institute of Allergy and Infectious Diseases and the National Cancer institute at the NIH used a variety of CAM therapies to cope with their diseases and rigors of treatment and clinical trials.
References
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The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting.
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Understanding and Improving Patient Compliance
TL;DR: The problem of patient compliance, as well as the ability of the physician to understand, detect, and improve compliance are described in relation to a new model of health decisions and patient behavior.
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Contemporary unorthodox treatments in cancer medicine. A study of patients, treatments, and practitioners.
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