1082. A Study of the KNowledge And Beliefs Held by Patients Infected with HIV and Their HIV Health Care Providers Regarding Single Tablet Regimens (STR). (KNABSTR Study)
Session: Poster Abstract Session: HIV: Switching Antiretrovirals
Friday, October 9, 2015
Room: Poster Hall
Background: The patient-provider relationship is a significant mediator for patient knowledge and beliefs about HIV treatment. We conducted a pilot cross-sectional study to: 1) assess patient ART knowledge and provider perceptions of such knowledge; 2) gain insight into patient and provider beliefs regarding ART and perceived stigma.

Methods: From 2013-2014, we surveyed 100 HIV+ women and 100 HIV+ men equally divided between STRs and multiple tablet regimens (MTRs) and 25 HIV providers in 4 clinics. Providers responded to knowledge questions as they believed their patients would respond and to belief questions based on their own beliefs. 

Results: Knowledge: 40% of STR patients didn’t know their regimen contained > 2 medications; 54% didn’t know the consequences of intolerance; and 38% didn’t understand resistance may occur with frequently missed doses. Providers predicted: 55% would not know STRs contain > 2 medications and 22% the consequences of intolerance. 92% of patients rely on providers for ART education while providers believed 69% had this expectation. No differences in ART knowledge were noted between STR and MTR patients.

Beliefs: STR patients worried less about drug interactions (43% MTR vs 63% STR) and believed fewer side effects were associated with STRs (50% MTR vs 70% STR). MTR patients believed more pills equates to better treatment (31% MTR vs 10% STR). Providers had stronger beliefs than patients about the number of pills and increased side effects (p=0.0002) and interactions with other medications (p=0.001).

Perceived stigma: 46 % of patients believe it’s important not to be seen taking medications compared to 96% of providers (p=0.0001); 36% of both patients and providers would only discuss HIV with their provider.

Conclusion: Clinically relevant knowledge gaps exist for patients on STRs and patients on STRs and MTRs had different perceptions about medication. Providers’ understanding of patients’ knowledge and beliefs were deficient in important areas such as treatment education and resistance, and they perceive more stigma than patients. Addressing these deficits along with a more nuanced understanding of both patient and provider belief systems may enhance patient-provider communication, adherence, and therapeutic success.

 

Cynthia Frank, Ph.D.1, Tassos Kyriakides, PhD2, Audrey Omar, M.A.2, Gerald Friedland, MD, FIDSA3, Laurie Andrews, MPH1, Kathy Melbourne, PharmD, AAHIVP4 and Michael J. Kozal, MD5, (1)Yale University School of Medicine, Yale University, New Haven, CT, (2)Yale Center for Analytical Sciences, New Haven, CT, (3)Yale University School of Medicine, New Haven, CT, (4)Gilead Sciences, Foster City, CA, (5)Yale University School of Medicine and VA CT, New Haven, CT

Disclosures:

C. Frank, Gilead Sciences, Inc: Grant Investigator , Research support

T. Kyriakides, Gilead: Grant Investigator , Research support

A. Omar, Gilead Sciences, Inc: Grant Investigator , Research support

G. Friedland, None

L. Andrews, Gilead Sciences, Inc: Grant Investigator , Research support

K. Melbourne, Gilead Sciences: Employee and Shareholder , Salary

M. J. Kozal, Gilead: Grant Investigator , Grant recipient
Bristol Myers Squibb: Grant Investigator , Grant recipient
Glaxo: Grant Investigator , Grant recipient
Pfizer: Grant Investigator , Grant recipient
Hologic: Grant Investigator , Grant recipient
Viiv: Grant Investigator , Grant recipient
Abbvie: Grant Investigator , Grant recipient
Merck: Grant Investigator , Grant recipient

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