ABSTRACT
BACKGROUND AND OBJECTIVE: Antiretroviral efficacy is closely related to the degree of adherence. The aim of this study is to assess the association between psychosocial and demographic variables and adherence to antiretroviral treatment. PATIENTS AND METHODS: A cross-sectional survey of 320 patients under antiretroviral treatment was conducted in four Andalusian hospitals, using a semi-structured questionnaire given by health care professionals. RESULTS: Median age was 39.7 years. Nearly 12% of the sample was considered non-compliant to antiretroviral treatment. An interaction was observed between psychological morbidity and mental health quality of life scores. Among patients who presented psychological morbidity, a higher mental quality of life score was associated with a lower risk of non-compliance (P = 0.04). This association was not found among patients without psychological morbidity. Older age, homosexual or bisexual status and the use of injecting drugs for a shorter period of time was associated with non-compliance. CONCLUSIONS: Demographic and psychological factors have an influence on adherence to antiretroviral treatment.
Subject(s)
Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/psychology , HIV Infections/drug therapy , Patient Compliance , Socioeconomic Factors , Adult , Age Factors , Bisexuality , Comorbidity , Cross-Sectional Studies , Educational Status , Employment , Female , HIV Infections/epidemiology , HIV Infections/psychology , Homosexuality , Humans , Male , Marriage , Mental Disorders/epidemiology , Methadone/therapeutic use , Patient Compliance/psychology , Patient Compliance/statistics & numerical data , Quality of Life , Risk , Social Support , Spain/epidemiology , Substance Abuse, Intravenous/epidemiology , Surveys and Questionnaires , Viral LoadABSTRACT
Antecedentes y objetivo. La efectividad de los antirretrovirales está asociada de forma muy estrecha al grado de adhesión. Este trabajo pretende determinar la asociación de las variables demográficas y psicosociales con la adherencia al tratamiento antirretroviral. Pacientes y métodos. Se realizó un estudio transversal con 320 pacientes en tratamiento antirretroviral, atendidos en cuatro hospitales de la Comunidad Autónoma Andaluza. Se utilizó un cuestionario semiestructurado, administrado por personal sanitario. Resultados. La edad media de la muestra fue 39,7 años. El 11,9% de la muestra estudiada fue considerada no adherida al tratamiento antirretroviral. Se detectó una interacción entre la presencia de morbilidad psíquica y la puntuación del índice de salud mental (ISM). Así, entre aquellos que padecían morbilidad psíquica a una mejor calidad de vida mental se les asoció un menor riesgo de no adherirse al tratamiento (p = 0,04), no describiéndose esta asociación entre aquéllos sin morbilidad psíquica. Una mayor edad, ser homosexual y haber estado menos años como consumidor de drogas por vía parenteral mostraron una tendencia a asociarse a la no adherencia. Conclusiones. Los factores demográficos y psicosociales influyen en la adherencia al tratamiento antirretroviral (AU)
Background and objective. Antiretroviral efficacy is closely related to the degree of adherence. The aim of this study is to assess the association between psychosocial and demographic variables and adherence to antiretroviral treatment. Patients and methods. A cross-sectional survey of 320 patients under antiretroviral treatment was conducted in four Andalusian hospitals, using a semi-structured questionnaire given by health care professionals. Results. Median age was 39.7 years. Nearly 12% of the sample was considered non-compliant to antiretroviral treatment. An interaction was observed between psychological morbidity and mental health quality of life scores. Among patients who presented psychological morbidity, a higher mental quality of life score was associated with a lower risk of non-compliance (P = 0.04). This association was not found among patients without psychological morbidity. Older age, homosexual or bisexual status and the use of injecting drugs for a shorter period of time was associated with non-compliance. Conclusions. Demographic and psychological factors have an influence on adherence to antiretroviral treatment (AU)
Subject(s)
Male , Female , Humans , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/psychology , Patient Compliance/psychology , Patient Compliance/statistics & numerical data , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Quality of life is one of the most frequently used subjective measures in chronic health problems. The aim of this study is to analyze the association between clinical and therapeutic parameters, and 11 quality of life domains in HIV-infected patients. METHODS: A cross-sectional survey of 320 patients on antiretroviral treatment was conducted in four Andalusian hospitals (Spain). A semi-structured questionnaire was administered by health care professionals. Health-related quality of life was assessed with the MOS-HIV questionnaire, an instrument designed specifically for HIV-infected patients. RESULTS: Almost three-quarters of the population were men (73.4%); 35.6% had developed aids, and 88.1% were considered adherent to treatment. Patients with greater viral load presented lower quality of life scores for all the domains, except cognitive functioning. Patients who had developed aids showed poorer quality of life for 10 of the 11 domains. Patients with adequate adherence to antiretroviral treatment showed better quality of life for 10 domains. No statistically significant differences in the domain scores except for quality of life were found between patients with a treatment regimen including protease inhibitors and those without. CONCLUSION: The patient's clinical status and adherence affect not only survival, but also quality of life.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/psychology , Patient Compliance/statistics & numerical data , Quality of Life , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/psychology , Adult , Aged , CD4 Lymphocyte Count , Cross-Sectional Studies , Female , HIV Infections/drug therapy , Humans , Male , Middle Aged , Spain , Surveys and Questionnaires , Treatment Outcome , Viral LoadABSTRACT
Introducción. La calidad de vida es uno de los métodos de evaluación subjetiva más utilizados en enfermedades de carácter crónico. El objetivo de este estudio es analizar la asociación entre parámetros clínicos y terapéuticos y las 11 dimensiones de calidad de vida en pacientes infectados por el virus de la inmunodeficiencia humana (VIH). Métodos. Se realizó un estudio transversal con 320 pacientes en tratamiento antirretroviral de 4 hospitales andaluces. Se utilizó un cuestionario semiestructurado administrado por personal sanitario. La calidad de vida relacionada con la salud se midió a través del cuestionario MOS-HIV (Medical Outcomes Study HIV Health Survey), que es un instrumento específico para pacientes con VIH. Resultados. El 73,4% de los entrevistados eran varones, el 35,6% tenían sida y el 88,1% fue considerado adherente al tratamiento. Los pacientes con una mayor carga viral presentaron puntuaciones más bajas en todas las dimensiones de la calidad de vida, a excepción de la función cognitiva. Los pacientes con sida mostraron una peor calidad de vida en 10 de las 11 dimensiones. Aquéllos con una adherencia adecuada al tratamiento antirretroviral mostraron una mejor calidad de vida en 10 dimensiones. No se detectaron diferencias estadísticamente significativas en las medias de las dimensiones del cuestionario MOS-HIV entre pacientes cuya combinación farmacológica incluía inhibidores de la proteasa y aquellos que no, a excepción de la dimensión de calidad de vida. Conclusión. El estado clínico y la adherencia del paciente no sólo afectan a su supervivencia, sino también a diferentes dimensiones de su calidad de vida (AU)
Introduction. Quality of life is one of the most frequently used subjective measures in chronic health problems. The aim of this study is to analyze the association between clinical and therapeutic parameters, and 11 quality of life domains in HIV-infected patients. Methods. A cross-sectional survey of 320 patients on antiretroviral treatment was conducted in four Andalusian hospitals (Spain). A semi-structured questionnaire was administered by health care professionals. Health-related quality of life was assessed with the MOS-HIV questionnaire, an instrument designed specifically for HIV-infected patients. Results. Almost three-quarters of the population were men (73.4%); 35.6% had developed aids, and 88.1% were considered adherent to treatment. Patients with greater viral load presented lower quality of life scores for all the domains, except cognitive functioning. Patients who had developed aids showed poorer quality of life for 10 of the 11 domains. Patients with adequate adherence to antiretroviral treatment showed better quality of life for 10 domains. No statistically significant differences in the domain scores except for quality of life were found between patients with a treatment regimen including protease inhibitors and those without. Conclusion. The patient's clinical status and adherence affect not only survival, but also quality of life (AU)
