ABSTRACT
Introduction:
The global
prevalence of
human immunodeficiency virus (
HIV) remains substantial, particularly in regions with limited
resources, despite the progress in scientific
knowledge and the accessibility of antiretroviral
therapy (
ART).
ART is the cornerstone of
HIV treatment. Ensuring proper adherence to medication
therapy is essential for effective
HIV infection control. Meanwhile,
Latvia reported one of the highest rates of
HIV infections among EU countries.
Purpose:
This study aimed to assess adherence levels to
ART among long-term users by utilizing the
National Health Service prescription electronic database
records. It is essential to determine whether non-adherence is a problem at the
state level.
Patients and
Methods:
This
retrospective study was conducted utilizing the Latvian
National Health Service's reimbursed
prescription database, covering the period from January 2017 to December 2018. The
analysis included
ART prescriptions.
Medication adherence was assessed using a Proportion of Days Covered (PDC) calculation. The adherence rates were categorized into three groups (1) < 80% (non-adherence), (2) 80% to 90% (suboptimal adherence), and (3) > 90% (optimal adherence) groups.
Results:
A total of 25,892 ARV medicines
prescription records for 1471
patients were analysed. The adherence level of long-term
ART was 38.3%. Of all
patients, only 37 (2.5%) had achieved an optimal and 25 (1.7%) suboptimal adherence level. Meanwhile, the remaining
patients (95.8%) were identified as non-adherent to
therapy. It has been determined that 96.1% (n=1414) of
patients experienced a
time gap of more than 90 days between their
prescriptions at least once. On average, each
patient had 3.5 of these gaps, with a maximum of 7 times.
Conclusion:
Medication adherence level to
ART is low in
Latvia. Less than 3% of
patients achieved optimal adherence levels with a PDC higher than 90%. These results are concerning. Further studies and interventions must be conducted to enhance adherence levels.