What We Know and What We Do Not Know About Factors Associated with and Interventions to Promote Antiretroviral Adherence
What We Know and What We Do Not Know About Factors Associated with and Interventions to Promote Antiretroviral Adherence
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DOI：
10.1007/s11908-015-0466-9
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发表时间：
2015-04-01
影响因子：
3.1
通讯作者：
Hirsch-Moverman, Yael
中科院分区：
文献类型：
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作者：
Mannheimer, Sharon;Hirsch-Moverman, Yael
坚持抗逆转录病毒治疗（ART）仍然是取得成功结果的关键。影响抗逆转录病毒治疗依从性的因素可能发生在个人层面，也可能与治疗方案、日常时间表和/或人际关系有关。虽然最近简化的ART方案减少了治疗相关的障碍，但指南仍然建议考虑方案的简单性。应在开始ART前评估ART准备情况，一旦开始ART，应在所有后续临床访视时进行随访依从性评估。坚持干预工作最好的时候，多方面的，有针对性的风险和非依从性的参与者，并根据个人的需要。成功的干预措施包括教育和咨询，提供社会支持，直接观察治疗和经济激励。药丸盒和双向短信服务（SMS）提醒已被证明是有效的，并被广泛推荐的工具，以促进抗逆转录病毒治疗的依从性。需要进一步的研究，以确定最佳组合的依从性干预措施，以及普遍性，实施和成本效益。
Antiretroviral therapy (ART) adherence remains critical for achieving successful outcomes. Factors affecting ART adherence can occur at the individual level or be related to the treatment regimen, daily schedule, and/or interpersonal relationships. While treatment-related barriers have diminished with recent simplified ART regimens, guidelines still recommend considering regimen simplicity. ART readiness should be assessed prior to starting ART, with follow-up adherence assessments once ART is initiated, and at all subsequent clinical visits. Adherence interventions work best when multifaceted, targeted for at-risk and nonadherent participants, and tailored to individuals' needs. Successful interventions have included education and counseling, provision of social support, directly observed therapy, and financial incentives. Pillboxes and two-way short-text messaging service (SMS) reminders have been shown to be effective and are widely recommended tools for promoting ART adherence. Further research is needed to determine the optimal combination of adherence interventions, as well as generalizability, implementation, and cost-effectiveness.