Adherence to treatment or placebo is linked to lower mortalityBMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7557.0 (Published 29 June 2006) Cite this as: BMJ 2006;333:0
All rapid responses
We read with interest the metaanalysis written by Professor Simpson
By looking at the data, it appears that 6868 patients out of the 46847
(15%) are HIV-positive. This current metaanalysis further supports recent
studies that show that adherence is an independent factor associated with
survival in HIV (Wood E, Hogg RS, Yip B, Moore D, Harrigan PR, Montaner
JS.Impact of baseline viral load and adherence on survival of HIV-infected
adults with baseline CD4 cell counts > or = 200 cells/microl.AIDS. 2006
May 12;20(8):1117-23.), or with CD4 count responses (Wood E, Hogg RS, Yip
B, Harrigan PR, O'Shaughnessy MV, Montaner JS.
The impact of adherence on CD4 cell count responses among HIV-infected
patients.J Acquir Immune Defic Syndr. 2004 Mar 1;35(3):261-8.).
A recently published study (Golin CE, Earp J, Tien HC, Stewart P, Porter
C, Howie L.A 2-arm, randomized, controlled trial of a motivational
intervention to improve adherence to antiretroviral therapy (ART) among
patients failing or initiating ART.J Acquir Immune Defic Syndr. 2006
May;42(1):42-51.) provides some evidence that motivational interviewing
may improve adherence with antiretroviral therapy.
Since the results of this metaanalysis might have been affected by the
special population of HIV positive patients, it might be worth designing a
study implementing adherence-improving methods in other that HIV patient
populations and measuring health-related outcomes.
Competing interests: No competing interests