Impact of a patient education program on adherence to HIV medication -: A randomized clinical trial

被引:117
作者
Goujard, C
Bernard, N
Sohier, N
Peyramond, D
Lançon, F
Chwalow, J
Arnould, B
Delfraissy, JF
机构
[1] Hop Bicetre, Dept Internal Med, F-94270 Le Kremlin Bicetre, France
[2] St Andre Hosp, Dept Infect Dis, Bordeaux, France
[3] Fedialis Med, Marly Le Roi, France
[4] Hop Croix Rousse, Dept Infect Dis, F-69317 Lyon, France
[5] Hop Hotel Dieu, Dept Diabetol, INSERM, Unit 341, Paris, France
[6] MAPI VALUES, Lyon, France
关键词
adherence; HIV; quality of life; patient education; antiretroviral therapy;
D O I
10.1097/00126334-200310010-00009
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Patients' knowledge of their HIV condition and its treatment, which has been recognized as a factor that influences adherence to antiretroviral therapy, can be improved through educational programs. This prospective, randomized, controlled trial compared an experimental group that participated in an educational program and a control group with standard care. The study evaluated the impact of an educational intervention on adherence to antiretroviral therapy, patients' knowledge. quality of life, and therapeutic response in patients treated with highly active antiretroviral therapy. Three hundred twenty-six patients were analyzed at inclusion. A higher level of adherence was associated with patients who were older, had higher incomes. and did not smoke. CD4 cell count and plasma viral load were correlated with adherence at entry. The educational intervention had an impact on adherence and knowledge in the experimental group at 6 months. which was maintained at 12 and 18 months. A delayed increase in adherence was observed in the control group at 12 months. No significant impact on quality of life was observed over time. The patients' health status improved in 56% of the experimental group subjects and 50% of the control subjects. However, no significant impact was shown on CD4 cell count and plasma viral load. This study shows that an educational intervention improves adherence to antiretroviral regimens and health status and suggests that it should be initiated early in therapy.
引用
收藏
页码:191 / 194
页数:4
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