Self-Reported Medication Adherence and Symptom Experience in Adults With HIV

The Journal of the Association of Nurses in AIDS Care: JANAC (Impact Factor: 1.27). 03/2011; 22(4):257-68. DOI: 10.1016/j.jana.2010.11.004
Source: PubMed


Symptom burden has been identified as a predictor of medication adherence, but little is known about which symptoms are most strongly implicated. This study examines self-reported medical adherence in relation to demographic, clinical, and symptom characteristics among 302 adults living with HIV. Only 12% reported missing medication during the 3-day assessment, but 75% gave at least one reason for missing it in the previous month. Poor adherence was associated with higher viral load and greater symptom burden. Trouble sleeping and difficulty concentrating were strongly associated with poor adherence. Given that "forgetting" was the most common reason for missing medication and nearly one third reported sleeping through dose time, future research should examine the influence of sleep disturbance on adherence. Effective management of common symptoms, such as sleep disturbance, fatigue, and gastrointestinal side-effects of medications may result in better adherence, as well as improved clinical outcomes and quality of life.

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Available from: Caryl Gay, Jul 18, 2014
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    • "Adherence to medication is poor when the illness is asymptomatic and chronic. Advanced illness as well as exposure to painful symptoms and side effects may result in a greater likelihood of the patient following the treatment as prescribed (Abel & Painter 2003, Battaglioli-DeNero 2007, Gay et al 2010). In one American study, disease severity was identified as playing a key role in adherence, as patients who have experienced complications from the disease may believe that they are at greater risk of their disease getting worse if they do not adhere to ARVs (Gao et al, 2002). "

    Full-text · Article · Jan 2015
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    • "al walls . Atheroscle - rosis is normally associated with older patients , and clinicians may not look for it in younger patients , especially if symptoms are attributed to medications , HIV , or depression . Chronic inflammation has been associated with an array of symptoms , which have been commonly re - ported by PLWH ( Edelman et al . , 2011 ; Gay et al . , 2011 ; Johnson et al . , 2003 ) . Because inflammation leads to epithelial barrier dysfunction and epithelial barrier dysfunction leads to microbial translocation , which results in inflammation , it is plausible that some symptoms can be linked to microbial translocation . In light of the association between inflammation and symptoms , we n"
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    ABSTRACT: Microbial translocation within the context of HIV disease has been described as one of the contributing causes of inflammation and disease progression in HIV infection. HIV-associated symptoms have been related to inflammatory markers and sCD14, a surrogate marker for microbial translocation, suggesting a plausible link between microbial translocation and symptom burden in HIV disease. Similar pathophysiological responses and symptoms have been reported in inflammatory bowel disease (IBD). We provide a comprehensive review of microbial translocation, HIV-associated symptoms, and symptoms connected with inflammation. We identify studies showing a relationship among inflammatory markers, sCD14, and symptoms reported in HIV disease. A conceptual framework and rationale to investigate the link between microbial translocation and symptoms is presented. The impact of inflammation on symptoms supports recommendations to reduce inflammation as part of HIV symptom management. Research in reducing microbial translocation-induced inflammation is limited, but needed, to further promote positive health outcomes among HIV-infected patients.
    Full-text · Article · Nov 2014 · Journal of the Association of Nurses in AIDS Care
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    • "18 1.1. Les effets indésirables des traitements antirétroviraux 19 Depuis l'avènement des multithérapies, la prise en charge des 20 patients séropositifs au virus d'immunodéficience humaine (VIH) 21 s'oriente vers une optimisation de leur observance et une 22 amélioration de leur qualité de vie sous traitement [14]. Or, 23 l'une comme l'autre sont particulièrement affectées par les effets 24 indésirables des traitements antirétroviraux, lesquels peuvent 25 toucher tant la sphère physique que psychique ou interpersonnelle 26 [24] [28] [29]. "
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    ABSTRACT: Pour comprendre le processus de subjectivation des effets indésirables des traitements antirétroviraux, nous étudions les relations entre les mécanismes de défense et la souffrance liée aux effets indésirables des traitements antirétroviraux. Soixante-trois sujets (43 hommes, 20 femmes) ont rempli le questionnaire de style défensif et une échelle d’évaluation des effets indésirables. Des corrélations entre la souffrance liée aux effets indésirables et les défenses sont trouvées (agression passive, clivage, déplacement, passage à l’acte, projection, refuge dans la rêverie et somatisation), ces corrélations diffèrent selon le genre des sujets. L’étude des interactions entre le genre sexuel, les manifestations biologiques des traitements et le fonctionnement défensif semble des plus pertinentes pour comprendre les processus de subjectivation des effets indésirables.
    Full-text · Article · Jan 2014 · Annales Médico-psychologiques revue psychiatrique
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