Paper
Tuesday, November 6, 2007

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This presentation is part of : HIV/AIDS and Infectious Disease Initiatives
Medication Adherence and Quality of Life in Patients with HIV/AIDS
Judith A. Erlen, RN, PhD, FAAN, Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA and Susan Sereika, PhD, Department of Health and Community Systems, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Learning Objective #1: describe the effect of the dose of a medication adherence intervention on changes in adherence and quality of life over time.
Learning Objective #2: describe the interrelationships among the dose of a medication adherence intervention, adherence, and quality of life over time.

Global health concerns for patients with HIV include medication adherence and quality of life. Limited research has tested the effect of medication adherence interventions on level of adherence and quality of life as a subsequent outcome of adherence. This multidisciplinary research team examined the relationships among the amount of intervention received, rate of medication adherence, and life satisfaction over time (R01 NR04749). This longitudinal randomized trial included 200 patients with HIV; 66.5% men, 61% white; and mean age of 40.6 years (SD=7.6). No significant group differences occurred between the control/usual care (n=101) or intervention (n=99) groups. Social cognitive theory guided the structured 12-week telephone intervention and 12-week tapered maintenance intervention designed to improve medication adherence in patients with HIV. Electronic event monitors were used to assess medication adherence and the Satisfaction with Life Scale (Diener et al.) was used to assess quality of life. Data collections occurred at baseline, post-intervention, and post-maintenance. Hierarchical regression analysis using data from baseline and post-intervention with adherence as percent of days with correct dosing showed a trend toward significance between dose of intervention and life satisfaction (p=.074); dose of intervention modified the relationship between adherence and life satisfaction (p=.042). No significant relationships were detected with adherence as percent of prescribed doses or percent of doses with correct timing and life satisfaction at either timepoint. Amount of intervention received may moderate the effect of a medication adherence intervention on quality of life. Delivering the full intervention may be necessary to improve adherence and quality of life. Possibly the Satisfaction with Life Scale is not sensitive enough to detect changes in quality of life; a multidimensional measure or multiple measures of quality of life may be necessary. Future research needs to address intervention strategies and health outcomes in more diverse samples of patients with HIV.