STRATEGIES TO MONITOR &
IMPROVE ADHERENCE

The patient-provider relationship is a factor in adherence and can have a positive influence if trust is developed through nonjudgmental and supportive care.1

  • The patient’s self-report is the most frequently used method for monitoring adherence1
  • The provider’s positive reinforcement through informing patients of their viral load levels and CD4 cell count can encourage adherence1

METHODS TO HELP FACILITATE PATIENTS’ ADHERENCE1,2

Reminder Methods

  • Medication reminders
  • Alarm clock
  • Calendar

Routine Methods

  • Pill organizers
  • Linking medication to daily activities

Mobile communications have been studied and demonstrated to be successful in supporting HIV treatment adherence among nonurban substance users, MSM who have fallen out of medical care, adolescents and young adults, and patients with remote access to care.3-6


Treatment selection can affect adherence. Consider both the regimen and the patient when making a prescription choice.1,7


Every time I have a patient who comes and they take all the medication I ask ‘Tell me, How do you do it?' and 'What helps you?'

And that has helped me to develop a repertoire of strategies that I share with my patients. Everyone has a strategy, and I think that, as providers, we are the depository of this community knowledge that we can share with our patients.

—Leandro Mena, MD

KEY WAYS TO IMPROVE
TREATMENT ADHERENCE

are discussed by a panel of HIV specialists.


REFERENCES:
  1. U.S. Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Available at
    https://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed November 16, 2017.
  2. Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25(4):462-473.
  3. Ingersoll KS, Dillingham RA, Hettema JE, et al. Pilot RCT of bidirectional text messaging for ART adherence among nonurban substance users with HIV. Health Psychol. 2015;34S:1305-1315.
  4. Storey D, Seifert-Ahanda K, Andaluz A, Tsoi B, Matuki JM, Cutler B. What is health communication and how does it affect the HIV/AIDS continuum of care? A brief primer and case study from New York City. J Acquir Immune Defic Syndr. 2014;66(suppl 3):S241-S249.
  5. Garofalo R, Kuhns LM, Hotton A, Johnson A, Muldoon A, Rice D. A randomized controlled trial of personalized text message reminders to promote medication adherence among HIV-positive adolescents and young adults. AIDS Behav. 2016;20(5):1049-1059.
  6. Smillie K, Van Borek N, Abaki J, et al. A qualitative study investigating the use of a mobile phone short message service designed to improve HIV adherence and retention in care in Canada (WelTel BC1). J Assoc Nurses AIDS Care. 2014;25(6):614-625.
  7. U.S. Department of Health and Human Services. Health Resources and Services Administration. Guide for HIV/AIDS Clinical Care—2014 Edition. Rockville, MD: U.S. Department of Health and Human Services; 2014.