April/May #163 : Doing the Dose - by Laura Whitehorn

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April / May 2010

Doing the Dose

by Laura Whitehorn

Swallowing your drugs day in, day out can be tough. The key to good adherence requires you to identify any obstacles—and to craft an individualized method to overcome them.

Some common strategies previously thought to help positive people take their daily meds have proved ineffective. Last fall, a study in the Journal of Acquired Immune Deficiency Syndromes reported that peer support, pager messages or a combination of the two failed to keep people on their drug schedules. The trial, involving 224 HIV-positive people in Seattle, also confirmed that the standard method of adherence support—discussions with staff at clinic visits—falls short too.

The researchers concluded that adherence strategies should be tailored for each person, because everybody has a different reason for missing meds.

For example, researchers at Harvard Medical School in Boston found that African-American men who think HIV meds are poison and cause AIDS don’t take them regularly. (Perhaps, given this belief, that’s not surprising.) The research, conducted among 214 African-American men living with HIV, determined that those who distrust antiretroviral drugs take, on average, no more than 68 percent of their prescribed doses.

HIV educator Lisa Diane White, program director at Atlanta’s longtime AIDS service organization SisterLove, says the results mirror her experiences working with African- American men. To help change the men’s minds and ensure better health, she says, “I tell them that their HIV is toxic to the body and their immune system is in need of help.” She doesn’t discredit their feelings, though, because the drugs do have toxicities.

The key is to tailor the messaging to the specific issues or obstacles of the individual. And since good adherence is the best way to ensure your virus doesn’t become resistant to your current drug regimen, we say find what works best for you and stick with it.   

Adherence Tips
If you are looking to improve your adherence—or preparing to start a new regimen—it’s important to discuss the fears or challenges you might face with your health care provider. Here are a few simple tips and tools from AIDSmeds.com that may help you better adhere to your HIV meds:

Keep your meds next to something you use regularly, on a daily basis. Examples include your coffee pot, your alarm clock or your toothbrush.

Program your cell phone to set off an alarm. People may be less likely to ask about your cell phone ringing than an alarm on a watch or other device.

If you travel frequently, always bring your meds in your carry-on luggage, and bring a few extra doses in case of flight delays and cancellations.

One-week, two-week and one-month pill boxes are available to help you lay out your meds in advance.

Some pharmacies will sort out your daily dose of meds and organize and package them in blister packs rather than putting them into pill bottles.

If you regularly need to take your meds on the go, check out portable pocket-sized pill cases. Some have alarm clocks built in.

What works for you?  Post your adherence tips as a comment below.

Search: adherence, schedules, antiretroviral drugs, prescription, toxic, resistant

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