Illness Perceptions, Medication Beliefs, and Adherence to Antiretrovirals and Medications for Comorbidities in Adults With HIV Infection and Hypertension or Chronic Kidney Disease.
Illness Perceptions, Medication Beliefs, and Adherence to Antiretrovirals and Medications for Comorbidities in Adults With HIV Infection and Hypertension or Chronic Kidney Disease.
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DOI：
10.1097/qai.0000000000001075
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发表时间：
2016-12-01
期刊：
影响因子：
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通讯作者：
Wyatt CM
中科院分区：
文献类型：
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作者：
Weiss JJ;Konstantinidis I;Boueilh A;Fierer DS;Gardenier D;Barber MG;Kang T;Kress A;Ericson K;Lira MC;Yostos MP;Bogner HR;Wisnivesky JP;Wyatt CM
艾滋病毒感染患者的死亡率越来越多地归因于合并症。需要研究合并症药物治疗依从性与抗逆转录病毒（ARV）药物治疗依从性的关系，以及艾滋病毒和合并症的疾病认知和药物治疗信念之间的相互关系如何影响药物治疗依从性，以告知依从性干预措施。高血压（n=151）或慢性肾脏疾病（CKD; n=41）的HIV感染的成年人从一个学术医疗中心的门诊实践招募。对艾滋病、高血压或慢性肾脏病的疾病认知和用药信念进行评估，并对一种抗逆转录病毒药物和一种高血压或慢性肾脏病药物的依从性进行电子监测，持续10周。抗逆转录病毒药物的服用率、剂量和时间依从性与高血压或CKD药物的依从性没有差异，除了患者对抗逆转录病毒药物的时间依从性（78%）高于抗高血压药物的时间依从性（68%;p=0.01）。与高血压相比，患者认为艾滋病毒更容易理解，更慢性，具有更多的负面后果，并引发更多的情绪。患者认为抗逆转录病毒药物比治疗高血压或CKD的药物更有必要。对抗逆转录病毒药物的疗效有现实的看法（r=-0.20;p<0.05）和对艾滋病毒的高度理解（r=0.21;p<0.05）与更好的抗逆转录病毒药物依从性相关。艾滋病毒感染者坚持使用抗逆转录病毒药物的比例与合并症药物相似，尽管他们认为艾滋病毒更具威胁性，抗逆转录病毒药物更重要。这可以用于调整现有的抗逆转录病毒药物依从性干预措施，以包括对共病药物的依从性。
Mortality in patients with HIV infection is increasingly due to comorbid medical conditions. Research on how adherence to medications for comorbidities relates to antiretroviral (ARV) medication adherence and how interrelations between illness perceptions and medication beliefs about HIV and comorbidities affect medication adherence is needed to inform adherence interventions. HIV-infected adults with hypertension (n=151) or chronic kidney disease (CKD; n=41) were recruited from ambulatory practices at an academic medical center. Illness perceptions and medication beliefs about HIV and hypertension or CKD were assessed and adherence to one ARV medication and one medication for either hypertension or CKD was electronically monitored for ten weeks. Rates of taking, dosing, and timing adherence to ARV medication did not differ from adherence to medication for hypertension or CKD, with the exception that patients were more adherent to the timing of their ARV (78%) than to the timing of their anti-hypertensive (68%;p=0.01]. Patients viewed HIV as better understood, more chronic, having more negative consequences, and eliciting more emotions, compared to hypertension. Patients viewed ARVs as more necessary than medication for hypertension or CKD. Having a realistic view of the efficacy of ARVs (r=−0.20;p<0.05) and a high level of perceived HIV understanding (r=0.21;p<0.05) correlated with better ARV adherence. HIV patients showed similar rates of adherence to ARVs as to medications for comorbidities, despite perceiving HIV as more threatening and ARVs as more important. This can be used in adapting existing interventions for ARV adherence to encompass adherence to medications for comorbid conditions.