Document Detail

Patients' perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework.
MedLine Citation:
PMID:  17514019     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the utility of the necessity-concerns framework in predicting highly active antiretroviral therapy (HAART) uptake and adherence. METHODS: This was a prospective follow-up study. Consecutive patients who were not currently receiving HAART were referred by their HIV physician. Immediately after a recommendation of HAART, patients completed the Beliefs about Medicines Questionnaire assessing their perceptions of personal necessity for HAART and concerns about potential adverse effects. The influence of these beliefs on the decision to accept or decline HAART and adherence 12 months later were assessed. RESULTS: One hundred fifty-three participants were given a recommendation of HAART, and 136 (88.9%) returned completed questionnaires. Thirty-eight participants (28%) initially rejected the treatment offer. Uptake of HAART was associated with perceptions of personal necessity for treatment (odds ratio [OR]=7.41, 95% confidence interval [CI]: 2.84 to 19.37) and concerns about potential adverse effects (OR=0.19, 95% CI: 0.07 to 0.48). There was a significant decline in adherence over time. Perceived necessity (OR=2.19, 95% CI: 1.02 to 4.71) and concerns about adverse effects (OR=0.45, 95% CI: 0.22 to 0.96), elicited before initiating HAART, predicted subsequent adherence. These associations were independent of clinical variables and depression. CONCLUSIONS: The necessity-concerns framework is a useful theoretic model for understanding patient perspectives of HAART and predicting uptake and adherence, with implications for the design of evidence-based interventions.
Robert Horne; Vanessa Cooper; Grace Gellaitry; Heather Leake Date; Martin Fisher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  45     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  334-41     Citation Subset:  IM; X    
Centre for Behavioural Medicine, Department of Policy and Practice, The School of Pharmacy, University of London, and Brighton University Hospital, National Health Service Trust, The Lawson Unit, United Kingdom.
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MeSH Terms
Anti-HIV Agents* / therapeutic use
Antiretroviral Therapy, Highly Active
Great Britain
HIV Infections* / drug therapy
Health Knowledge, Attitudes, Practice*
Longitudinal Studies
Patient Compliance
Treatment Refusal
Reg. No./Substance:
0/Anti-HIV Agents

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