|Nederlandse titel proefschrift||Therapietrouw, Kwaliteit van leven en de ouder wordende HIV-1 geïnfecteerde patiënt|
|Engelse titel proefschrift||Treatment Adherence, Health Related Quality of Life and Aging in HIV-1 infected patients|
|Gepromoveerde is verpleegkundige (geweest)|
|Universiteit||Universiteit van Amsterdam|
|Promotores||Promotoren: prof. dr. M.A.G. Sprangers & prof. dr. P. Reiss. Copromotor: dr. P.T. Nieuwkerk|
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.
|Proefschrift downloaden (Engels)||Proefschrift-Langebeek-N.pdf|