Tags

Type your tag names separated by a space and hit enter

Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse.
AIDS. 2004 Jan 01; 18 Suppl 1:S19-25.AIDS

Abstract

OBJECTIVE

To examine the predictors of antiretroviral adherence among HIV-infected adults, with a particular focus on advancing age, neuropsychological dysfunction, and substance abuse.

DESIGN

: Prospective observational design.

METHODS

Participants were 148 HIV-infected adults between the ages of 25 and 69 years, all on a self-administered antiretroviral regimen. Medication adherence was tracked over a one-month period using an electronic monitoring device (medication event monitoring system caps). All participants completed a comprehensive battery of neuropsychological tests as well as a structured psychiatric interview.

RESULTS

The mean adherence rate for the entire cohort was 80.7%, with older patients (> or = 50 years) demonstrating significantly better medication adherence than younger patients (87.5 versus 78.3%). Logistic regression analyses found that older patients were three times more likely to be classified as good adherers (defined as > or = 95% adherent). Neurocognitive impairment conferred a 2.5 times greater risk of poor adherence. Among the older patients, those who were classified as poor adherers performed significantly worse on neuropsychological testing, particularly on measures of executive function and psychomotor speed. Current drug abuse/dependence, but not current alcohol abuse/dependence, was also associated with sub-optimal medication adherence.

CONCLUSION

Although older age is associated with higher rates of antiretroviral adherence, older participants who were cognitively impaired showed disproportionate difficulty in adequately adhering to their medication regimen. As such, efforts to detect neuropsychological dysfunction, particularly among older patients, and a thorough assessment of substance abuse, appear to be essential for the effective treatment of HIV-infected adults.

Authors+Show Affiliations

Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles,and Psychology Service, VA Greater Los Angeles Health Care System, 90024, USA. chinkin@ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15075494

Citation

Hinkin, Charles H., et al. "Medication Adherence in HIV-infected Adults: Effect of Patient Age, Cognitive Status, and Substance Abuse." AIDS (London, England), vol. 18 Suppl 1, 2004, pp. S19-25.
Hinkin CH, Hardy DJ, Mason KI, et al. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004;18 Suppl 1:S19-25.
Hinkin, C. H., Hardy, D. J., Mason, K. I., Castellon, S. A., Durvasula, R. S., Lam, M. N., & Stefaniak, M. (2004). Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS (London, England), 18 Suppl 1, S19-25.
Hinkin CH, et al. Medication Adherence in HIV-infected Adults: Effect of Patient Age, Cognitive Status, and Substance Abuse. AIDS. 2004 Jan 1;18 Suppl 1:S19-25. PubMed PMID: 15075494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AU - Hinkin,Charles H, AU - Hardy,David J, AU - Mason,Karen I, AU - Castellon,Steven A, AU - Durvasula,Ramani S, AU - Lam,Mona N, AU - Stefaniak,Marta, PY - 2004/4/13/pubmed PY - 2004/6/29/medline PY - 2004/4/13/entrez SP - S19 EP - 25 JF - AIDS (London, England) JO - AIDS VL - 18 Suppl 1 N2 - OBJECTIVE: To examine the predictors of antiretroviral adherence among HIV-infected adults, with a particular focus on advancing age, neuropsychological dysfunction, and substance abuse. DESIGN: : Prospective observational design. METHODS: Participants were 148 HIV-infected adults between the ages of 25 and 69 years, all on a self-administered antiretroviral regimen. Medication adherence was tracked over a one-month period using an electronic monitoring device (medication event monitoring system caps). All participants completed a comprehensive battery of neuropsychological tests as well as a structured psychiatric interview. RESULTS: The mean adherence rate for the entire cohort was 80.7%, with older patients (> or = 50 years) demonstrating significantly better medication adherence than younger patients (87.5 versus 78.3%). Logistic regression analyses found that older patients were three times more likely to be classified as good adherers (defined as > or = 95% adherent). Neurocognitive impairment conferred a 2.5 times greater risk of poor adherence. Among the older patients, those who were classified as poor adherers performed significantly worse on neuropsychological testing, particularly on measures of executive function and psychomotor speed. Current drug abuse/dependence, but not current alcohol abuse/dependence, was also associated with sub-optimal medication adherence. CONCLUSION: Although older age is associated with higher rates of antiretroviral adherence, older participants who were cognitively impaired showed disproportionate difficulty in adequately adhering to their medication regimen. As such, efforts to detect neuropsychological dysfunction, particularly among older patients, and a thorough assessment of substance abuse, appear to be essential for the effective treatment of HIV-infected adults. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/15075494/Medication_adherence_in_HIV_infected_adults:_effect_of_patient_age_cognitive_status_and_substance_abuse_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=15075494.ui DB - PRIME DP - Unbound Medicine ER -