| Paradoxical effects of clinician emphasis on adherence to combination antiretroviral therapy for HIV/AIDS. | |
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MedLine Citation:
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PMID: 16623625 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Constructive relationships between clinicians and patients being treated for HIV/AIDS are critical to treatment success. Trust, caring, and expertise have all been cited as important components of such relationships. As-yet unexamined, however, is the impact of the urgency patients sense in their clinicians concerning proper adherence to antiretroviral medications. Qualitative interviews (total, 214) from a study of adherence to highly active antiretroviral therapy (HAART) for active illegal drug users (n = 52) provided data for the analysis. Among other topics, interviews examined patients' perspectives on relationships with their providers. Study participants experienced their physicians as insisting on perfect adherence. Fearing disapproval if they disclosed missing doses, interviewees chose instead to conceal adherence information. Apprehensions about failing at perfect adherence led some to cease taking antiretrovirals over the course of the study. Well-intentioned efforts by clinicians to emphasize the importance of adherence can paradoxically undermine the very behavior they are intended to promote. Adherence can be approached in ways that inspire honesty and openness and build trust in the treatment relationship, laying the groundwork for a collaborative approach to solving problems in taking antiretroviral medications as prescribed. |
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Authors:
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Toni Tugenberg; Norma C Ware; Monique A Wyatt |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: AIDS patient care and STDs Volume: 20 ISSN: 1087-2914 ISO Abbreviation: AIDS Patient Care STDS Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-20 Completed Date: 2006-06-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9607225 Medline TA: AIDS Patient Care STDS Country: United States |
Other Details:
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Languages: eng Pagination: 269-74 Citation Subset: IM; X |
Affiliation:
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Department of Social Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA. toni_tugenberg@hms.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-HIV Agents
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therapeutic use* Antiretroviral Therapy, Highly Active Communication Female HIV Infections / drug therapy*, psychology Humans Interviews as Topic Male Patient Compliance* / psychology Physician-Patient Relations* Physicians Substance-Related Disorders |
| Grant Support | |
ID/Acronym/Agency:
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R01 DA13340/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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