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Author Topic: Bad Adherence Can Kill  (Read 1721 times)

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Bad Adherence Can Kill
« on: November 17, 2010, 01:23:56 PM »
I guess I felt compelled to post this after reading another members issues with remembering to take their meds as well as thinking of stopping them. I post this with only good intentions. I wish everyone here the strength and wisdom to make good decisions and do what is best for them.

The whole article can be found here: http://www.thebody.com/content/art12281.html#adherence

Bad Adherence Can Kill

Before people with HIV began taking potent antiretrovirals, the retrovirus killed nearly everyone it infected. In countries that cannot provide antiretrovirals for HIV-infected people, those people are dying today. So it should be no surprise that people who can get antiretrovirals -- but take them haphazardly or not at all -- will die as well.

Anyone who doubts that bad adherence kills might consult two studies in British Columbia, where antiretrovirals are free. The first involved 1,281 antiretroviral-naive adults beginning triple therapy between August 1996 and December 1999.9 Defining "intermittent therapy" as filling fewer than 75 percent of prescriptions in the first year of treatment, University of British Columbia researchers used a multivariate model to isolate only two factors that raised the risk of death: Each 100-cell decrement in pretreatment CD4 count raised the risk 1.31 times, and intermittent therapy raised the risk 2.90 times (P<0.001 for both). The researchers ran a subanalysis on people with at least one year of follow-up to eliminate a statistical bias called downward drift -- the chance that less frequent use of antiretrovirals in the first year simply marked more rapid HIV disease progression. This subanalysis confirmed the tie between poor adherence and death.

A more recent and larger study by the same group found that poor adherence outweighed baseline CD4 count in predicting mortality.39 Everyone in the 1,422-person cohort started potent antiretroviral therapy between August 1, 1996 and July 31, 2000. Follow-up continued until March 31, 2002. Again the Vancouver team figured adherence by prescription filling and limited statistical scrutiny to the first year of treatment.
« Last Edit: November 17, 2010, 02:52:59 PM by nychope1 »


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