Why is highly active antiretroviral therapy (HAART) not prescribed or discontinued? Swiss HIV Cohort Study

Details

Serval ID
serval:BIB_E379FE6C804E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Why is highly active antiretroviral therapy (HAART) not prescribed or discontinued? Swiss HIV Cohort Study
Journal
Journal of Acquired Immune Deficiency Syndromes
Author(s)
Bassetti  S., Battegay  M., Furrer  H., Rickenbach  M., Flepp  M., Kaiser  L., Telenti  A., Vernazza  P. L., Bernasconi  E., Sudre  P.
ISSN
1525-4135 (Print)
Publication state
Published
Issued date
06/1999
Volume
21
Number
2
Pages
114-9
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jun 1
Abstract
In this cross-sectional survey conducted at the end of 1997 among the physicians of participants of the Swiss HIV Cohort Study (SHCS), 1487 of 2154 patients (69.0%) were treated with highly active antiretroviral treatment (HAART) defined as triple therapy with a combination of one or two reverse transcriptase inhibitors, and one or two protease inhibitors; 541 patients (25.1%) had never received such treatment. The physician's perception that the patient would not comply with treatment was one reason for not prescribing HAART to 20% of these patients (110). Physicians indicated that the most common reasons for the patient to refuse HAART were the fear of side effects (18%) and the patient's perception that treatment was too complicated (18%). Among 126 patients (5.8%) no longer receiving HAART, the most common reasons for discontinuing treatment were actual side effects (61%) or the fear of side effects (25%). Overall, 16% of patients did not receive therapy in accord with official Swiss guidelines. Multivariate logistic regression analysis indicated that patients with lower education, active intravenous drug users outside of a drug substitution program, and those who acquired HIV infection through intravenous drug use had a significantly higher risk of inadequate treatment. The physician's judgment of patient adherence and the physician's perception of the patient's fear of side effects are critical for the prescription of HAART. Physicians should address these issues to prevent unilateral withholding of treatment and increase the proportion of patients who may benefit from current antiretroviral therapy.
Keywords
Anti-HIV Agents/adverse effects/*therapeutic use CD4 Lymphocyte Count Cohort Studies Cross-Sectional Studies Drug Therapy, Combination Drug Utilization Education Female Guideline Adherence HIV Infections/*drug therapy/psychology HIV Protease Inhibitors/adverse effects/therapeutic use Humans Male Patient Compliance/psychology *Physician's Practice Patterns *Prescriptions, Drug Reverse Transcriptase Inhibitors/adverse effects/therapeutic use Risk Factors Substance Abuse, Intravenous Switzerland Treatment Refusal/psychology
Pubmed
Web of science
Create date
29/01/2008 8:52
Last modification date
20/08/2019 16:07
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