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Once Daily Dosing Improves Adherence to Antiretroviral Therapy

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Abstract

We studied the association of once-daily dosing with self-reported adherence among participants of the Ontario Cohort Study who were currently taking ART and who had completed a 90-min interviewer-administered questionnaire. Suboptimal adherence was defined as missing ≥1 dose of ART in the 4 days prior to the interview. Participants (n = 779) were 85% male, 69% men having sex with men, 67% white, median age 48 years (IQR 42–54), median years of ART 9 (IQR 5–13) and median CD4 count 463 cells/mm3 (IQR 320–638). Fifteen percent of participants reported suboptimal adherence in the 4 days prior to the interview. In a multivariable logistic regression model, participants on once daily regimens were half as likely to miss a dose during the 4 days prior to the interview. Other independent correlates of suboptimal adherence were younger age, lower positive social interaction and increased frequency of consuming > 6 alcoholic drinks on one occasion.

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Acknowledgments

The OHTN Cohort Study (Principal Investigator, Dr. Sean B. Rourke) is supported by the AIDS Bureau—Ontario Ministry of Health and Long-Term Care. Data collection sites and members of the Scientific Steering Committee include: Drs. Irving Salit and Janet Raboud (Toronto General Hospital), Dr. Ahmed Bayoumi (St. Michael’s Hospital), Drs. Mona Loutfy, Graham Smith, Tony Antoniou and Fred Crouzat (Maple Leaf Medical Clinic), Dr. Anita Rachlis, Dr. Nicole Mittmann (Sunnybrook Health Sciences Centre), Dr. Wendy Wobeser (Kingston General Hospital), Dr. John Cairney (McMaster University and Centre for Addiction and Mental Health), Dr. Liviana Calzavara (University of Toronto), Dr. Curtis Cooper (University of Ottawa), Dr. Marek Smieja (McMaster University, Hamilton), Dr. Ken Logue (St Clair Medical Associates), Dr. Don Kilby (University of Ottawa Health Services), Dr. Anurag Markenday (St. Joseph’s Health Care, London), Dr. Roger Sandre (Sudbury Regional Hospital and Dr. Jeff Cohen (Windsor Clinic).

We gratefully acknowledge all of the people living with HIV who volunteer to participate in the OHTN Cohort Study and the work and support of the inaugural OCS Governance Committee: Darien Taylor (Chair), Dr. Evan Collins, Dr. Greg Robinson, Shari Margolese, Patrick Cupido, Tony Di Pede, Rick Kennedy, Michael Hamilton, Ken King, Brian Finch, Lori Stoltz, Dr. Ahmed Bayoumi, Dr. Clemon George, and Dr. Curtis Cooper. We thank all the interviewers, data collectors, research associates and coordinators, nurses and physicians who provide support for data collection and extraction. The authors wish to thank the OHTN staff and their teams for data management and IT support (Mark Fisher, Director, Data Systems) and OCS management and coordination (Virginia Waring, Project Manager, OCS). The viral load data in the OCS was supplemented through a linkage with the viral load database of the Ontario Agency for Health Protection and Promotion.

Six investigators are also the recipients of salary support from the Ontario HIV Treatment Network (JR, SW, CC), the Canadian Institutes of Health Research (MRL, MS, SR).

Conflicts of Interest

There are no conflicts of interest related to this paper and project.

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Authors and Affiliations

  1. Division of Infectious Disease, University Health Network, Room 5-244, 60 Murray Street, Box 18, Toronto, ON, M5T 3L9, Canada

    Janet Raboud, Maggie Li, Sharon Walmsley, Sandra Blitz & Evan Collins

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Janet Raboud

  3. Departments of Medicine and Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Sharon Walmsley, Ahmed M. Bayoumi, Sean Rourke, Anita Rachlis & Mona R. Loutfy

  4. The University of Ottawa, The Ottawa Hospital Division of Infectious Diseases, Ottawa, ON, Canada

    Curtis Cooper

  5. Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael’s Hospital, Toronto, ON, Canada

    Ahmed M. Bayoumi, Sean Rourke & Sergio Rueda

  6. Ontario HIV Treatment Network, Toronto, ON, Canada

    Sean Rourke & Sergio Rueda

  7. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Sean Rourke & Evan Collins

  8. Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Anita Rachlis

  9. Health Outcomes and Pharmaco Economics (HOPE) Research Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Nicole Mittmann

  10. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada

    Marek Smieja

  11. Maple Leaf Medical Clinic, Toronto, ON, Canada

    Mona R. Loutfy

  12. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada

    Mona R. Loutfy

Authors
  1. Janet Raboud
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  2. Maggie Li
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  3. Sharon Walmsley
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  12. Evan Collins
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  13. Mona R. Loutfy
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Corresponding author

Correspondence to Janet Raboud.

Appendix A: Positive Social Interaction Score

Appendix A: Positive Social Interaction Score

The positive social interaction score was the sum of the answers to the following four questions, “How often do you have available …”

  • Someone to have a good time with

  • Someone to get together with for relaxation

  • Someone to do something enjoyable with

  • Someone to do something with to help you get your mind off things

Each of these items was scored as:

  • None of the time (1)

  • A little of the time (2)

  • Some of the time (3)

  • Most of the time (4)

  • All of the time (5)

The total score was tabulated and then were transformed to a scale from 0 to 100 with the following formula: 100 × (observed score − minimum possible score)/(maximum possible score − minimum possible score).

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Raboud, J., Li, M., Walmsley, S. et al. Once Daily Dosing Improves Adherence to Antiretroviral Therapy. AIDS Behav 15, 1397–1409 (2011). https://doi.org/10.1007/s10461-010-9818-5

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