|English title dissertation||Treatment Adherence, Health Related Quality of Life and Aging in HIV-1 infected patients|
|Name PhD (surname first)||Langebeek Nienke|
|Doctor is (has been) nurse|
|Date of promotion||08/06/2017|
|University||Universiteit van Amsterdam|
|Promotores||Reiss P., Sprangers M.A.G., Nieuwkerk P.T (co-promotor)|
Treatment adherence, health related quality of life and aging in HIV-1 infected patients
A meta-analysis on predictors and correlates of adherence to cART showed that adherence was most strongly associated with patients’ adherence-related beliefs. It suggest several potential options for interventions to improve adherence.
One intervention, simplification of therapy to a fixed-dose was perceived to be more convenient, and resulted in improved adherence.
There is no golden standard to measure adherence. A combination of methods were compared including EMD, diaries, self-reports, physician and nurse assessments, pill-counts, pharmacy refill, in-depth-interviews and TDM. The conclusion was that patient’s self-reports, the estimation by nurse and the combination with TDM are easy to implement and can be used successfully in daily practice.
Another meta-analysis was carry out to assess the effectiveness of EMD combined with informed counselling. The contribution of just monitoring-informed counselling to improve levels of adherence and virological treatment response is difficult to establish. It reflects that adherence is a behaviour that may be affected by a multitude of factors addressed by multi-component interventions.
The age of HIV-1 infected adults increasing and therefore the onset of age-associated co-morbidities increases which may negatively affect HRQL.
Abbriviations: cART: combination antiretroviral therapy; EMD: electronic monitoring device; TDM: therapeutic drug monitoring; HRQL: helath related quality of life
|Download dissertation (English)||PR-IPS-NienkeLangebeek-binnenwerk-DEF-UIT-low.pdf|