Sergio Rueda|Laura Park-Wyllie|Ahmed M. Bayoumi|Anne-Marie Tynan|Tony Antoniou|Sean B. Rourke|Richard H. Glazier
Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS
St. Michael's Hospital|St. Michael's Hospital|University of Toronto|St. Michael's Hospital|St. Michael's Hospital|University of Toronto|St. Michael's Hospital
background adherence prescribed regimens required derive maximal benefit many highly active antiretroviral therapy haart regimens people living hivaids objectives conduct systematic review research literature effectiveness patient support education improve adherence haart search methods systematic search electronic databases performed january 1996 may 2005 selection criteria randomized controlled trials examining effectiveness patient support education improve adherence haart considered inclusion studies measured adherence minimum six weeks included data collection analysis study selection quality assessments data abstraction performed independently two reviewers main results nineteen studies involving total 2159 participants met criteria inclusion possible conduct metaanalysis due study heterogeneity respect populations interventions comparison groups outcomes length followup sample sizes ranged 22 367 populations studied ranged general hivpositive populations studies focusing exclusively children women latinos adults history alcohol dependence studies focusing almost exclusively men study interventions included cognitive behavioral therapy motivational interviewing medication management strategies interventions indirectly targeting adherence programs directed reduce risky sexual behaviours ten studies demonstrated beneficial effect intervention adherence found interventions targeting practical medication management skills administered individuals vs groups interventions delivered 12 weeks associated improved adherence outcomes also found interventions targeting marginalized populations women latinos patients past history alcoholism successful improving adherence unable determine whether effective adherence interventions associated improved virological immunological outcomes studies several methodological shortcomings leaving vulnerable potential biases authors conclusions found evidence support effectiveness patient support education interventions intended improve adherence antiretroviral therapy interventions targeting practical medication management skills interventions administered individuals vs groups interventions delivered 12 weeks associated improved adherence outcomes need standardization increased methodological rigour conduct adherence trials