ADHERENCE TO ANTIRETROVIRAL THERAPY IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 18
Abstract
BACKGROUND The Million Death Study Collaborators in the British Medical Journal have estimated that the people living with HIV/AIDS population to be between 1.4-1.6 million. Development of Antiretroviral Therapy (ART) has been one of the dramatic advances in the history of medicine. Among several factors that can affect the ART outcome, adherence to the ART has been cited as a major factor associated with poor outcomes. For ART to have maximum effect greater than 95%, adherence has been suggested. Additionally, non adherence to ART is a major cause of HIV drug resistance. Especially, in the Indian context, adherence to ART is very important due to the sheer number of HIV/AIDS cases, the socioeconomic status, diversity of the population and regions. That is, the socioeconomic challenges faced by patients contribute to nonadherence to ART in India. With this background, this study was done with the primary objective of assessing the level of adherence to the given regimen of ART as per the NACO guidelines and factors influencing adherence. MATERIALS AND METHODS This is a prospective patient record-based study conducted in the Antiretroviral Therapy Centre at MKCG Medical College, Berhampur, from January 2016 to June 2016. Simple random sampling technique was used to select 150 patients’ records from the ART Centre of the medical college. The data was collected in a predesigned case record form from the patient card available at antiretroviral therapy centre. The patients were followed up through the patient card for six months from their recruitment. The adherence to treatment was evaluated using the adherence score adopted by NACO where a score of 1, 2 and 3 implied that 95%, 80-95% and <80% of the medication were taken respectively. The adherence score were further analysed with reference to the sociodemographic characteristics and the adverse drug reactions encountered during the therapy. Descriptive statistics was used to analyse and report the data Graph Pad Prism V 2.0 (trial version). RESULTS There was a predominance of male patients over females with the maximum number of cases were in the age group of 35 to 44 years and majority of the subjects are uneducated, married and unemployed. More than 90% patients had an adherence score of 1 (>95% medication taken). Persons with primary education, married individuals and persons without employment had better improvement in adherence score than other groups. Anaemia was the predominant adverse drug reaction encountered. CONCLUSION The findings of this study imply that, to increase the adherence to therapy and reduce dropout the nonadherent groups need to be targeted. This will prevent the development of drug resistance and treatment failure.
Authors and Affiliations
Muralidhara Panigrahi, Chandra Sekhar Maharana, Pradyut Kumar Pradhan
Keywords
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- EP ID EP215038
- DOI 10.18410/jebmh/2017/205
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