Specialist Pharmacist. Hospital Universitario de Valme. Southern Healthcare Area, Sevilla. Spain..
Clinical and Research Division. Secretariat of the Spanish AIDS Plan, Ministerio de Sanidad, Madrid. Spain..
Farm Hosp. 2020 Jul 1;44(4):163-173. doi: 10.7399/fh.11441.
Adherence to treatment in patients living with HIV remains the focus of attention of health professionals and researchers. However, patient profiles and the available therapeutic arsenal have changed greatly over the last decade. Inadequate adherence not only to antiretroviral therapy but also to other prescribed drugs remains the main cause of therapeutic failure. There are several factors associated with poor adherence and others that facilitate it, hence the importance of identifying, managing and correcting situations that may hinder adherence. Likewise, adherence should be periodically reassessed during the follow-up of ART and other prescribed drugs. It has so far proved impossible to find a single method capable of providing a reliable measurement of adherence. That is why it is necessary to use a combination of multiple easy- to-implement methods. Additionally, a good relationship with the patient facilitates the conveyance of adequate information on adherence. It is currently considered that interventions to improve adherence should be multidisciplinary, individualized and adjusted to the new patterns of infection transmission, and that controlling adherence to other drugs prescribed to patients with HIV should be part of such interventions. This document provides an update on the recommendations published in 2008 based on a review of the scientific literature. The main goal is to help healthcare professionals dedicated to the clinical and therapeutic management of HIV patients (doctors, pharmacists, nurses, psychologists and social workers) improve adherence of such patients to all the drugs prescribed to them as treatment for their HIV infection.
艾滋病病毒感染者的治疗依从性仍然是卫生专业人员和研究人员关注的焦点。然而,过去十年中,患者的特征和可用的治疗武器库发生了很大变化。不仅抗逆转录病毒治疗,而且其他规定药物的依从性不足仍然是治疗失败的主要原因。有几个因素与不依从有关,而其他因素则有助于提高依从性,因此,确定、管理和纠正可能阻碍依从性的情况非常重要。同样,在接受抗逆转录病毒治疗和其他规定药物治疗的随访期间,应定期重新评估依从性。到目前为止,还没有找到一种单一的方法能够可靠地测量依从性。这就是为什么有必要结合使用多种易于实施的方法。此外,与患者建立良好的关系有助于提供有关依从性的充分信息。目前认为,提高依从性的干预措施应该是多学科的、个体化的,并根据新的感染传播模式进行调整,控制艾滋病病毒感染者服用的其他药物的依从性应成为此类干预措施的一部分。本文件根据对科学文献的审查,提供了 2008 年发布的建议的最新情况。主要目标是帮助专门从事艾滋病毒患者临床和治疗管理的医疗保健专业人员(医生、药剂师、护士、心理学家和社会工作者)提高这些患者对所有规定药物的依从性,这些药物被规定用于治疗他们的艾滋病毒感染。