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Original article

Vol. 142 No. 2930 (2012)

Information about medication in HIV-infected patients and its relation to adherence

  • Virginie Korb-Savoldelli
  • Florence Gillaizeau
  • Thibaut Caruba
  • Patrice Prognon
  • Pierre Durieux
  • Brigitte Sabatier
Cite this as:
Swiss Med Wkly. 2012;142:w13642


QUESTIONS UNDER STUDY: In HIV-infected patients, comprehension of medication instructions is an essential condition for adherence to Highly Active Antiretroviral Therapy (HAART). In this study, we used a self-reported questionnaire to know which sources of medication information HIV-infected patients used and their impact on adherence. In secondary objectives, we determined profiles of non-adherent patients and specified the role of the pharmacist.

METHODS: A cross-sectional, observational study was conducted in one community pharmacy and one French university hospital pharmacy, in HAART-naïve or not patients, from April to June 2009.

RESULTS: During the 3-month study period, 233 HIV-infected patients were included. The majority of patients sought information about their HAART treatments from the hospital physician (79.8%), the community physician (74.2%), and patient information leaflets (73.8%). The community and hospital pharmacists were consulted by respectively 16.3% and 3.4% of patients. According to multivariate regression analysis, adherence seemed to be associated with the sources of information “community physician”, “hospital physician”, “internet”, and the potential support of patient associations. A total of 65.7% of patients were considered to be adherent.

CONCLUSIONS: In our study, among sources used by HIV-infected outpatients, their physicians are the most helpful sources of information about HAART. Regarding practice implications, the key role of the pharmacist is underutilised, indicating the need for improved communication between the pharmacist and outpatients.


  1. Konkle-Parker DJ, Erlen JA, Dubbert PM. Lessons learned from an HIV adherence pilot study in the deep south. Patient Educ Couns. 2010;78:91–6.
  2. Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30.
  3. Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000;14:357–66.
  4. Bangsberg DR, Charlebois ED, Grant RM, Holodniy M, Deeks SG, Perry S, et al. High levels of adherence do not prevent accumulation of HIV drug resistance mutations. AIDS. 2003;17:1925–32.
  5. Bangsberg DR, Perry S, Charlebois ED, Clark RA, Roberston M, Zolopa AR, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15:1181–3.
  6. Wood E, Hogg RS, Yip B, Harrigan PR, O’Shaughnessy MV, Montaner JS. Is there a baseline CD4 cell count that precludes a survival response to modern antiretroviral therapy? AIDS. 2003;17:711–20.
  7. Gross R, Bilker WB, Friedman HM, BL Strom. Effect of adherence to newly initiated antiretroviral therapy on plasma viral load. AIDS. 2001;15:2109–17.
  8. Bartlett JA. Addressing the challenges of adherence. J Acquir Immune Defic Syndr. 2002;29(Suppl 1):S2–10.
  9. Nachega JB, Mugavero MJ, Zeier M, Vitoria M, Gallant JE. Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs. Patient Preference and Adherence. 2011;5:357–67.
  10. Walsh JC, Horne R, Dalton M, Burgess AP, Gazzard BG. Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. AIDS Care 2001;13:709–20.
  11. Ferguson TF, Stewart KE, Funkhouser E, Tolson J, Westfall AO, Saag MS. Patient-perceived barriers to antiretroviral adherence: associations with race. AIDS Care. 2002;14:607–17.
  12. Johnson J. Cancer-related information seeking., ed. I. Cresskil NJ: Hampton Press. 1997.
  13. Alexender S, Golin C, Kalinowski C. Provider-patient communication and treatment adherence. in Patient treatment adherence: concepts, interventions, and measurement., O.E. Bosworth H, Weinberger M, Editor. 2005, Lawrence Erlbaum: London. p. 329–72.
  14. DiMatteo MR. Patient adherence to pharmacotherapy: the importance of effective communication. Formulary. 1995;30:596–8, 601–2, 605.
  15. Hill H. A career as a.specialist HIV pharmacist. Hosp Pharm. 2006;1:15–6.
  16. Hesse BW, Nelson DE, GL Kreps, Croyle RT, Arora NK, Rimer BK, et al. Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med. 2005;165:2618–24.
  17. Huber JT, Cruz JM. Information needs and information-seeking behaviors of HIV positive men and women. Med Ref Serv Q. 2000;19:39–48.
  18. Narhi U. Sources of medicine information and their reliability evaluated by medicine users. Pharm World Sci. 2007;29:688–94.
  19. Rutten LJ, Arora NK, Bakos AD, Aziz N, J Rowland. Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Educ Couns. 2005;57:250–61.
  20. Sleath B, Wurst K, Lowery T. Drug information sources and antidepressant adherence. Community Ment Health J. 2003;39:359–68.
  21. Lewin SA, Skea ZC, Entwistle V, Zwarenstein M, Dick J. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev 2001; p. CD003267.
  22. Keshishian F, Colodny N, Boone RT. Physician-patient and pharmacist-patient communication: geriatrics’ perceptions and opinions. Patient Educ Couns. 2008;71:265–84.
  23. Bultman DC. Evaluation of written prescription information provided in community pharmacies. Final report 2002: Washington, DC.
  24. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. (Greenwich). 2008;10(5):348–54.
  25. Golin CE, DiMatteo MR, Gelberg L. The role of patient participation in the doctor visit. Implications for adherence to diabetes care. Diabetes Care. 1996;19:1153–64.
  26. Ley P. Communicating with patients: Improving communication, satisfaction and compliance. 1988, New York: Croom Helm.
  27. Arbuthnott A, Sharpe D. The effect of physician-patient collaboration on patient adherence in non-psychiatric medicine. Patient Educ Couns. 2009;77:60–7.
  28. (ABPI), A.o.t.B.P.I. Patient information: Advice on drafting of leaflets. 1988: London.
  29. Kalichman SC, Benotsch EG, Weinhardt LS, Austin J, Luke W. Internet use among people living with HIV/AIDS: association of health information, health behaviors, and health status. AIDS Educ Prev. 2002;14:51–61.
  30. Kalichman SC, Weinhardt L, Benotsch E, DiFonzo K, Luke W, Austin J. Internet access and Internet use for health information among people living with HIV-AIDS. Patient Educ Couns. 2002;46:109–16.
  31. Adherence to long-term therapies. Evidence for action. World Health Organization ed. 2003, Switzerland.
  32. Chesney M. Adherence to HAART regimens. AIDS Patient Care STDS. 2003;17:169–77.
  33. Panel on clinical practices for treatment of HIV. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents (NIH 2002). in Morbidity and mortality weekly report. 2002: Atlanta, GA, Centers for diseases control and prevention.
  34. Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, et al. AdICoNA Study Group. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S123–7.
  35. Michaud PA, Suris JC, Thomas R, Gnehm HE, Cheseaux JJ; Swiss HIV Mother+Child Cohort Study (MoCHiV). Coping with an HIV infection. A multicenter qualitative survey on HIV positive adolescents’ perceptions of their disease, therapeutic adherence and treatment. Swiss Med Wkly. 2010;140(17–18):247–53.
  36. Watermeyer J, Penn C. “Tell me so I know you understand”: pharmacists’ verification of patients’ comprehension of antiretroviral dosage instructions in a cross-cultural context. Patient Educ Couns. 2009;75:205–13.
  37. Harmon G, Lefante J, Krousel-Wood M. Overcoming barriers: the role of providers in improving patient adherence to antihypertensive medications. Curr Opin Cardiol. 2006;21(4):310–5.