Medication management skill in HIV: I. Evidence for adaptation of medication management strategies in people with cognitive impairment. II. Evidence for a pervasive lay model of medication efficacy

People with HIV-related cognitive impairment may change the way they manage medication regimens, relying on a fixed medication schedule each day to avoid missed doses. Using a medication recall diary, we identified people who took medication on exactly the same schedule over 3 days and those with more variable medication schedules. Patients with low scores on executive and psychomotor tests were more likely to report fixed medication schedules; memory performance, by contrast, was not associated with reported medication regimen. Patients with low scores on executive and psychomotor tests were also less accurate in pouring medicines in the Medication Management Test. More than three fourths of these HIV+ patients assumed that medicines with higher milligram dosages were stronger than medicines with smaller milligram dosages, even across different classes of medicines. In a non-HIV sample, 28% endorsed the belief, suggesting it is a widespread way of thinking about medication strength. A performance test of medication management sheds light on the ways patients take medicines and how beliefs about medicines affect medication regimens.