Prescribing and using self-injectable antiretrovirals: How concordant are physician and patient perspectives?

被引：7

作者：

Horne R. ^{[1
]}

Kovacs C. ^{[2
]}

Katlama C. ^{[3
]}

Clotet B. ^{[4
]}

Fumaz C.R. ^{[5
]}

Youle M. ^{[6
]}

Kulasegaram R. ^{[7
]}

Fisher M. ^{[8
]}

Cohen C. ^{[9
]}

Slim J. ^{[10
]}

Shalit P. ^{[11
]}

Cooper V. ^{[1
]}

Tsoukas C. ^{[12
]}

机构：

[1] Department of Policy and Practice, The School of Pharmacy, University of London, London

[2] Department of Medicine, University of Toronto, Maple Leaf Medical Clinic, Toronto, ON

[3] Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris

[4] Institut de Recerca de la SIDA-Caixa Foundation, Barcelona

[5] Lluita contra la SIDA Foundation, Barcelona

[6] Royal Free Centre for HIV Medicine, London

[7] Department of Genito-Urinary Medicine, Guy's and St. Thomas' National Health Service Foundation Trust, London

[8] Department of HIV/Genitourinary Medicine, Brighton and Sussex University Hospitals, National Health Service Foundation Trust, Brighton

[9] Community Research Initiative of New England, Boston, MA

[10] Saint Michael's Medical Center, Newark, NJ

[11] Swedish Medical Center, Seattle, WA

[12] Montreal General Hospital, Montreal, QC

来源：

AIDS Research and Therapy | / 6卷 / 1期

关键词：

Belief Statement; Enfuvirtide; Treatment Refusal; Treatment Offer; High Prescriber;

D O I：

10.1186/1742-6405-6-2

中图分类号：

学科分类号：

摘要：

Background: The selection of agents for any treatment regimen is in part influenced by physician and patient attitudes. This study investigated attitudinal motivators and barriers to the use of self-injectable antiretroviral agents among physicians and patients and measured the degree of concordance between physician and patient perspectives. Methods: Attitudes toward prescribing and usage of self-injectable antiretroviral therapy (SIAT) were assessed by structured interview in 2 cohorts sampled from the European Union and the USA: 499 HIV-treating physicians and 603 treatment-experienced HIV-infected patients. Motivators and barriers to prescribing SIAT were identified from statistical analysis of the associations between physicians' ratings of enfuvirtide-based therapy compared to standard oral-based therapy and 2 indicators of enfuvirtide prescribing behavior. Patients' attitudes were assessed by their responses to a written profile of enfuvirtide and their ratings of the likelihood of accepting a treatment offer. Results: Both indicators of SIAT prescribing behavior were predicted by the same pattern of physician beliefs. Nonprescribing was associated with: (1) the belief that offering enfuvirtide would be perceived negatively by patients, leading to treatment refusal and nonadherence; (2) the belief that prescribing enfuvirtide is harder to justify in terms of time/resources; and (3) a lack of confidence in the efficacy and use of enfuvirtide in practice (all p < 0.05). However, physicians' beliefs were not in concordance with patients' views. After reading a profile of enfuvirtide, 76% patients said that they would be moderately or highly likely to accept a treatment offer, although most (72%) had not discussed enfuvirtide with their doctor. Patients' beliefs predicted the likelihood of accepting enfuvirtide. Conclusion: Physician and patient beliefs about SIAT influence prescribing behavior and compliance yet may not be concordant, with patients having more positive attitudes towards SIAT than anticipated by physicians. © 2009 Horne et al; licensee BioMed Central Ltd.

引用

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