NDLI: Spillover adherence effects of fixed-dose combination HIV therapy

Content Provider	PubMed Central
Author	Kauf, Teresa L. Davis, Keith L. Earnshaw, Stephanie R. Davis, E. Anne
Copyright Year	2012
Abstract	The impact of fixed-dose combination (FDC) products on adherence to other, non-fixed regimen components has not been examined. We compared adherence to a third antiretroviral (ART) component among patients receiving a nucleoside reverse transcriptase inhibitor (NRTI) backbone consisting of the FDC Epzicom®, GlaxoSmithKline Inc, Research Triangle Park, NC (abacavir sulfate 600 mg + lamivudine 300 mg; FDC group) versus NRTI combinations taken as two separate pills (NRTI Combo group) using data from a national sample of 30 health plans covering approximately 38 million lives from 1997 to 2005. Adherence was measured as the medication possession ratio (MPR). Multivariate logistic regression compared treatment groups based on the likelihood of achieving ≥95% adherence, with sensitivity analyses using alternative thresholds. MPR was assessed as a continuous variable using multivariate linear regression. Covariates included age, gender, insurance payer type, year of study drug initiation, presence of mental health and substance abuse disorders, and third agent class. The study sample consisted of 650 FDC and 1947 NRTI Combo patients. Unadjusted mean adherence to the third agent was higher in the FDC group than the NRTI Combo group (0.92 vs 0.85; P < 0.0001). In regression analyses, FDC patients were 48% and 39% more likely to achieve 95% and 90% third agent adherence, respectively (P ≤ 0.03). None of the other MPR specifications achieved comparable results. Among managed care patients, use of an FDC appears to substantially improve adherence to a third regimen component and thus the likelihood of achieving the accepted standard for adherence to HIV therapy of 95%.
Related Links	http://dx.doi.org/10.2147/ppa.s28482
Ending Page	164
Starting Page	155
File Format	PDF
ISSN	1177889X
e-ISSN	1177889X
Journal	Patient preference and adherence
Volume Number	6
Language	English
Publisher	Dove Medical Press
Publisher Date	2012-02-01
Access Restriction	Open
Rights Holder	Dove Medical Press
Subject Keyword	Health Policy Social Sciences (miscellaneous) Medicine (miscellaneous) Pharmacology, Toxicology and Pharmaceutics (miscellaneous) Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Social Sciences Pharmacology, Toxicology and Pharmaceutics Health Policy

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