684. Differences in calculated adherence rates of ART and non-ART medications among HIV positive veterans
Session: Poster Abstract Session: Adherence, Retention in Care, and the HIV Cascade
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • Hiro IDSA Poster Final.pdf (347.0 kB)
  • Background: As cardiovascular disease is increasingly recognized as an important cause of morbidity and mortality among HIV-infected patents, management of non-HIV chronic diseases including hypertension, diabetes mellitus, and dyslipidemia, is also becoming more important among aging HIV-infected population.  Although adherence to ART has been studied extensively, adherence to non-ART medications has not.  We compared adherence to antiretroviral therapy (ART) and non-ART medications among HIV-infected patients in a Veterans Affairs HIV clinic.

    Methods: A retrospective chart review was conducted on a cohort of HIV-infected patients followed in the HIV clinic at Louis Stokes Cleveland Department of Veterans Affairs Medical Center, prescribed both ART and non-ART medications for more than 365 days continuously by ID clinic provider between 1/1/2011 and 12/31/2012.  Measures of medication adherence, calculated by proportion of days covered (PDC) based on prescription date and days of medication supply, were compared between ART and non-ART medications.

    Results: Total 458 ART and 667 non-ART medications were included from 171 patients (162 men and 9 women, mean age 54.6).  A paired-samples t-test comparing means of ART and non-ART medications of each patient showed a significant difference in PDC of ART (mean 85.8, SD 17.8) and PDC of non-ART medications (mean 77.0, SD 18.0), conditions; t (170), p < 0.001.  Mean difference of 8.8% in PDC suggests non-ART medications covered 32.1 days less than ART in 365-days observation period.  Age, medication copayment exemption status, history of depression, substance abuse, alcohol abuse were not correlated with difference in PDC of non-ART medications and ART by multiple linear regression. Mean PDC of major non-ART medications are; multivitamin 75.6% (n=57), lisinopril 85.8% (n=46), hydrochlorthiazide 89.5% (n=38), omeprazole 74.3% (n=31), pravastatin 80.6% (n=23), citalopram 76.2% (n=19), and hydrochlorthiazide/lisinopril 85.4% (n=19).

    Conclusion: PDC of non-ART medications was lower than PDC of ART in a HIV clinic in VA by 8.8%. Patients who are otherwise adherent to their ART are less adherent with their non-ART medications. Interventions to improve medication adherence should also include non-ART medications in addition to ART.

    Fumihiro Kodama, MD, Marion Skalweit, MD, PhD, Christopher Burant, PhD and Amy Hirsch, Pharm.D., BCPS, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH


    F. Kodama, None

    M. Skalweit, None

    C. Burant, None

    A. Hirsch, None

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