HIV Treatment Noncompliance More Likely In Younger Patients

02-06-2007 | Categories:

Age-Associated Predictors of Medication Adherence in HIV-Positive Adults: Health Beliefs, Self-Efficacy, and Neurocognitive Status. Barclay, Terry R.; Hinkin, Charles H.; Castellon, Steven A.; Mason, Karen I.; Reinhard, Matthew J.; Marion, Sarah D.; Levine, Andrew J.; Durvasula, Ramani S. Health Psychology. 2007 Jan Vol 26(1) 40-49

Abstract available at ~Age-Associated Predictors of Medication Adherence in HIV-Positive Adults: Health Beliefs, Self-Efficacy, and Neurocognitive Status~

The Study

This prospective study investigated the relationship of adherence to antiretroviral therapy to demographic characteristics, health beliefs and attitudes, treatment self-efficacy, and neurocognitive status.

Neuropsychological test performance and health beliefs and attitudes were measured while medication adherence was electronically tracked over a 1-month period using MEMS (Medication Event Monitoring System caps).

Results & Conclusion

The rate of poor adherence was twice as high among younger participants than with older participants (68% and 33%, respectively). Results of binary logistic regression revealed that low self-efficacy and lack of perceived treatment utility predicted poor adherence among younger individuals, whereas decreased levels of neurocognitive functioning remained the sole predictor of poor adherence among older participants. These data support components of the health beliefs model in predicting medication adherence among younger HIV-positive individuals. However, risk of adherence failure in those ages 50 years and older appears most related to neurocognitive status.


Commentary

While the impact of this study on the health beliefs model is questionable, the increased likelihood of noncompliance in younger patients and the link between noncomplianced and neurocognitive status could prove to be clinically useful correlatives.



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