The impact of neurobehavioral features on medication adherence in HIV: evidence from longitudinal models.
Title | The impact of neurobehavioral features on medication adherence in HIV: evidence from longitudinal models. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Panos, SE, Del Re, AC, Thames, AD, Arentsen, TJ, Patel, SM, Castellon, SA, Singer, EJ, Hinkin, CH |
Journal | AIDS Care |
Volume | 26 |
Issue | 1 |
Pagination | 79-86 |
Date Published | 2014 Jan |
ISSN | 1360-0451 |
Keywords | Adult, Antiretroviral Therapy, Highly Active, Anxiety Disorders, Behavioral Symptoms, Depression, Drug Therapy, Combination, Female, HIV Infections, Humans, Internal, Longitudinal Studies, Male, Medication Adherence, Middle Aged, Models, Biological, Predictive Value of Tests, Self Efficacy |
Abstract | Effective antiretroviral therapy has led to substantial improvements in health-related outcomes among individuals with HIV. Despite advances in HIV pharmacotherapy, suboptimal medication adherence remains a significant barrier to successful treatment. Although several factors have been associated with medication adherence in the extant literature, study assessing the effects of some of the neurobehavioral features specific to HIV has been limited. Moreover, although there is a growing body of literature measuring medication adherence in HIV prospectively, few employ advanced statistical methodologies suited to handle advanced models with multiple predictors that would strengthen our understanding of medication adherence trajectories in HIV. This study sought to integrate traditionally assessed predictors of medication adherence with neurobehavioral features of HIV in a longitudinal study of medication adherence to combined antiretroviral therapy (cART). The current study used multilevel modeling to examine a wide arrangement of categories of factors - demographic, medication related, psychosocial, and neurobehavioral - on medication adherence. The sample consisted of 235 HIV+ individuals whose medication adherence was monitored over the course of six months using electronic monitoring devices. After controlling for the effects of demographic, medication, and psychosocial factors, neurobehavioral features added predictive validity to the model. In the final model, simultaneously controlling for the effects of each of the predictors within all the categories, age, self-efficacy, executive functioning, apathy, and frequency of stimulant use emerged as unique individual predictors of average medication adherence across the 6-month study. Self-efficacy and irritability predicted changes in medication adherence over time. Adherence behavior is multidetermined. Adequate assessment of these factors, combined with timely intervention, appears to be warranted in order to boost adherence rates. |
DOI | 10.1080/09540121.2013.802275 |
Alternate Journal | AIDS Care |
PubMed ID | 23756102 |
PubMed Central ID | PMC4408322 |
Grant List | R01 DA013799 / DA / NIDA NIH HHS / United States U24 MH100929 / MH / NIMH NIH HHS / United States T32 MH019535 / MH / NIMH NIH HHS / United States R25 MH080663 / MH / NIMH NIH HHS / United States K23 MH095661 / MH / NIMH NIH HHS / United States R01 DA13799 / DA / NIDA NIH HHS / United States K23MH095661 / MH / NIMH NIH HHS / United States T32 MH19535 / MH / NIMH NIH HHS / United States |