Swan Holly, Reisman Joel I, McDannold Sarah E, Glickman Mark E, McInnes D Keith, Gifford Allen L
a Edith Nourse Rogers Memorial VA , Bedford , MA , USA.
b Department of Health Law, Policy & Management , Boston University School of Public Health , Boston , MA , USA.
AIDS Care. 2018 Aug;30(8):997-1003. doi: 10.1080/09540121.2018.1437254. Epub 2018 Feb 7.
Patients who attribute their symptoms to HIV medications, rather than disease, may be prone to switching antiretrovirals (ARVs) and experience poor retention/adherence to care. Gastrointestinal (GI) symptoms (e.g., nausea/vomiting) are often experienced as a side effect of ARVs, but little is known about the relationship of symptom attribution and bothersomeness to adherence. We hypothesized that attribution of a GI symptom to ARVs is associated with a reduction in adherence, and that this relationship is moderated by the bothersomeness of the symptom. Data for our analysis come from the pre-randomization enrollment period of a larger study testing an adherence improvement intervention. Analyses revealed that patients with diarrhea who attributed the symptom to ARVs (compared to those who did not) had significantly worse adherence. We did not find a significant moderating effect of bothersomeness on this relationship. Incorporating patient beliefs about causes of symptoms into clinical care may contribute to improved symptom and medication management, and better adherence.
将自身症状归因于抗逆转录病毒药物而非疾病的患者，可能倾向于更换抗逆转录病毒药物（ARV），并在坚持治疗/护理方面表现不佳。胃肠道（GI）症状（如恶心/呕吐）通常是抗逆转录病毒药物的副作用，但关于症状归因和困扰程度与坚持治疗之间的关系，我们所知甚少。我们假设，将胃肠道症状归因于抗逆转录病毒药物与坚持治疗的降低有关，并且这种关系会受到症状困扰程度的调节。我们分析的数据来自一项测试改善坚持治疗干预措施的大型研究的随机分组前入组阶段。分析显示，将腹泻症状归因于抗逆转录病毒药物的患者（与未归因的患者相比）坚持治疗的情况明显更差。我们没有发现困扰程度对这种关系有显著的调节作用。将患者对症状原因的看法纳入临床护理，可能有助于改善症状和药物管理，并提高坚持治疗的程度。
