News Release

Study profiles HIV patients who best comply with medication schedules

Peer-Reviewed Publication

NIH/National Institute on Drug Abuse

In a study to assess the effects of age, substance abuse, and neuropsychological function on adherence to antiretroviral treatment among HIV-infected adults, researchers found that patients over the age of 50 who did not abuse drugs and who were free of cognitive impairment had the best adherence rates.

Medication adherence is critically important for HIV infected adults. Studies have shown that good adherence (typically defined as 90-95 percent of doses taken as prescribed) has been linked to improved health status and reduced mortality rates. Patients who do not meticulously adhere to the medication regimen are at risk for a worsening of their HIV disease, including possibly developing strains of the virus that no longer respond to standard HIV medications.

The investigators tracked medication usage over a one-month period in 148 HIV-infected individuals between the ages of 25 and 69, all of whom were on a self-administered antiretroviral regimen. All of the participants were tested for HIV-related cognitive impairment that can include memory problems, difficulties with planning and judgement, and a slowing of the brain's ability to process information.

Patients over the age of 50 were three times more likely to be properly adherent to their medication schedule--defined as taking 95 percent of the prescribed medications--than were younger patients. Fifty-three percent of the patients over 50 achieved this standard compared to 26 percent of the younger patients.

Testing showed that 83 percent of the patients over the age of 50 who had poor adherence to the medication regimen had some cognitive impairment. Current drug abuse was also associated with poor medication adherence. More than 90 percent of the patients who were current drug abusers failed to adequately adhere to the medication regimen.

WHAT IT MEANS: This study documents the importance of assessing cognitive function--particularly among older patients-- and drug abuse status when treating HIV-infected adults. In order to maximize compliance, the medication regimen may need to be simplified or assistance may need to be provided for those found to have cognitive impairments.

A research team led by Dr. Charles Hinkin of the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Health Care System conducted this study with funding provided by the National Institute on Drug Abuse and the National Institute of Mental Health. The findings were published in the December 24, 2002 issue of the journal Neurology and will appear in an upcoming special issue of the journal AIDS.

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