Beliefs about antiretroviral therapy, treatment adherence and quality of life in a 48-week randomised study of continuation of zidovudine/lamivudine or switch to tenofovir DF/emtricitabine, each with efavirenz

• Published in: AIDS care 2011-06, Vol.23 (6), p.705-713
• Main Authors: Cooper, Vanessa, Moyle, Graeme J., Fisher, Martin, Reilly, Geraldine, Ewan, Jacqueline, Liu, Hui C., Horne, Rob, for the SWEET (Simplification With Easier Emtricitabine Tenofovir) group, UK
• Format: Article
• Language: English
• Subjects: Adenine - administration & dosage; Adenine - analogs & derivatives; Adherence; Adult; Aged; AIDS; AIDS/HIV; Anti-HIV Agents - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active - psychology; Antiviral agents; Belief & doubt; Beliefs; beliefs about medicines; Benzoxazines - administration & dosage; Biological and medical sciences; combivir; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Drug Combinations; Drug Substitution - psychology; Drug therapy; Drug Therapy, Combination - methods; Emtricitabine; Female; Health care; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - drug therapy; HIV Infections - psychology; HIV-1; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Intrusiveness; Lamivudine - administration & dosage; Male; Medical care; Medical sciences; Medical treatment; Medication Adherence - psychology; Medicine; Mental health; Middle Aged; Necessity; Organophosphonates - administration & dosage; Perceptions; Pharmacology. Drug treatments; Quality of life; Quality of Life - psychology; Side effects; Tenofovir; Treatment Outcome; truvada; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Zidovudine - administration & dosage
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2010.534433

Adherence may be facilitated by reducing perceptual and practical barriers to antiretroviral therapy (ART). Practical barriers include the complexity of daily dosing, while perceptual barriers include perceptions of the need for treatment and concerns about adverse effects. The study aim was to assess the effect of switching zidovudine plus lamivudine twice-daily (Combivir, CBV) to once-daily tenofovir DF plus emtricitabine (Truvada, TVD), each plus efavirenz (EFZ), on adherence, beliefs about ART and quality of life (QoL). Subjects stable on CBV + EFV were randomised 1:1 to continue this regimen or switch to TVD + EFV. Adherence was measured using the Medication Adherence Self-Report Inventory at 4, 12, 24 and 48 weeks. Beliefs about ART (perceptions of necessity and concerns about adverse effects), treatment intrusiveness and QoL were measured by questionnaire at baseline 4, 12, 24 and 48 weeks. Viral load was assessed at each visit. Two hundred and thirty-four subjects initiated treatment. At week 48, the proportion of subjects reporting high adherence (≥95% taken as prescribed) was significantly greater in the TVD arm (p=0.049). Low adherence (reporting taking