Influence of the number of daily pills and doses on adherence to antiretroviral treatment: a 7-year study

What is known and objectiveAntiretroviral treatment (ART) is hampered by complicated regimens, high pill burden, drug-drug interactions, and frequent short- and long-term adverse effects, leading to decreased adherence. Over recent years, considerable effort has been directed at developing regimens that are less burdening. We undertook a 7-year retrospective study of the records of 264 HIV-infected subjects enrolled in a pharmaceutical care programme to document the progress made and to study the influence of the number of ART pills and doses on the level of treatment adherence. MethodsAntiretroviral dispensing records were analysed for the number of pills and doses administered and the ART adherence rate estimated. Results and discussionIn 2005, the patients took a mean of 62 pills daily (CI 95%: 59-66), and 929% of them were on a twice-a-day (BID) dosage regimen. By 2012, the mean number of pills was reduced to 41 (CI 95%: 38-44), and only 509% were on a BID regimen. No statistically significant relation was observed between number of daily pills and doses and ART adherence reached by the patients in any of the analyses performed. What is new and conclusionsThere has been a continuous reduction in the number of pills and doses of antiretrovirals taken by individual patients over the last 7 years due largely to the introduction of improved treatments and regimens. More daily pills or doses was not associated with worse ART adherence in our pharmaceutical care programme.