Effects of a Program on Correction and Persistence of Antiretroviral Treatment to Improve Adherence and Drug Safety in HIV/AIDs Patients at Uthumpornphisai Hospital, Sisaket Province, Thailand - ผลของการส่งเสริมการกินยาต้านไวรัสอย่างถูกต้อง และสม่ำเสมอต่อความร่วมมือและความปลอดภัยจากการใช้ยาในผู้ป่วยและผู้ติดเชื้อเอดส์โรงพยาบาลอุทุมพรพิสัย จังหวัดศรีสะเกษ

Abstract

            Acquired immune deficiency syndrome (AIDS) is a disease that requires lifelong and correct treatment with antiretroviral drugs to prevent opportunistic infection and drug resistance. In B.E. 2554 (2011) and 2555 (2012), there were 4.70 % and 4.20 % of drug resistant cases at Uthumpornphisai hospital, respectively. Poor adherence is a crucial cause of therapeutic failure. Therefore, HIV patient health care practitioner team of the hospital has worked together to improve adherence in order to reduce
drug resistance and to improve safety. The objective of this study was to evaluate the effects of a program to improve correction and persistence of antiretroviral medication toward adherence and drug safety in HIV/AIDs patients. It was designed a retrospective-interrupted time study which enrolled 120 patients. Interventions included patient education by training, group activities, individual and group counseling. Evaluation tools used in this study included pill count, medication record and interviews. It was found that the percentage of patients with correct and persistent antiretroviral medication increased significantly from 81.06% in the year 2013 to 94.50% in 2014 (p<0.001) with correlated increase of CD4 level. Drug resistance was found in 2 cases from 120 HIV patients in the year 2556 and 2 cases from 118 HIV patients in the year 2557. The stable rate of drug resistance might help saving cost treatment by avoiding the need to use more expensive second line drugs. Adverse drug events were observed in 5 patients (4.17%) in 2013 and 2 patients (1.67%) in 2014. Because of the intervention, 2 cases with adverse drug reaction knew the cause and promptly informed physician and promptly visited the hospital. Serious side effects were not found in this study. In conclusion, the program wasv effective in improving compliance
of antiretroviral medication in HIV/AIDs patients. Therefore, this approach should be promoted and replicated as one of the effective guidelines for HIV patient care.

Key words: HIV/AIDs, correction and persistence of drug use, drug resistance, adverse drug reaction