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Adherence to Antiretroviral Treatment and Correlation with Risk of Hospitalization among Commercially Insured HIV Patients in the United States

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  • Paul E Sax
  • Juliana L Meyers
  • Michael Mugavero
  • Keith L Davis

Abstract

Purpose: A lower daily pill burden may improve adherence to antiretroviral treatment (ART) and clinical outcomes in patients with human immunodeficiency virus (HIV). This study assessed differences in adherence using the number of pills taken per day, and evaluated how adherence correlated with hospitalization. Methodology: Commercially insured patients in the LifeLink database with an HIV diagnosis (International Classification of Diseases, 9th Revision, Clinical Modification code 042.xx) between 6/1/2006 and 12/31/2008 and receipt of a complete ART regimen were selected for inclusion. Patients were grouped according to their daily pill count and remained on ART for at least 60 days. Outcomes included adherence and rates of hospitalization. Adherence was measured as the proportion of days between the start and end of the regimen in which the patient maintained supply of all initiated ART components. Logistic regressions assessed the relationship between pills per day, adherence, and hospitalization, controlling for demographics, comorbidities, and ART-naïve (vs. experienced) status. Results: 7,073 patients met the study inclusion criteria, and 33.4%, 5.8%, and 60.8% received an ART regimen comprising one, two, or three or more pills per day, respectively. Regression analysis showed patients receiving a single pill per day were significantly more likely to reach a 95% adherence threshold versus patients receiving three or more pills per day (odds ratio [OR] = 1.59; P

Suggested Citation

  • Paul E Sax & Juliana L Meyers & Michael Mugavero & Keith L Davis, 2012. "Adherence to Antiretroviral Treatment and Correlation with Risk of Hospitalization among Commercially Insured HIV Patients in the United States," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-10, February.
    • Handle: RePEc:plo:pone00:0031591
    DOI: 10.1371/journal.pone.0031591
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    Cited by:

    1. Donna E. Sweet & Frederick L. Altice & Calvin J. Cohen & Björn Vandewalle, 2016. "Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-19, January.
    2. Fumiyo Nakagawa & Alec Miners & Colette J Smith & Ruth Simmons & Rebecca K Lodwick & Valentina Cambiano & Jens D Lundgren & Valerie Delpech & Andrew N Phillips, 2015. "Projected Lifetime Healthcare Costs Associated with HIV Infection," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-12, April.
    3. Laurent Cotte & Tristan Ferry & Pascal Pugliese & Marc-Antoine Valantin & Clotilde Allavena & André Cabié & Isabelle Poizot-Martin & David Rey & Claudine Duvivier & Antoine Cheret & Pierre Dellamonica, 2017. "Effectiveness and tolerance of single tablet versus once daily multiple tablet regimens as first-line antiretroviral therapy - Results from a large french multicenter cohort study," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-12, February.

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