Telephone nurse counseling improves HIV medication adherence: an effectiveness study

J Assoc Nurses AIDS Care. Jul-Aug 2009;20(4):316-25. doi: 10.1016/j.jana.2009.02.008.

Abstract

Antiretroviral therapy remains a challenge for persons living with HIV (PLWH), who must maintain high levels of adherence to prevent viral resistance and treatment failure. This effectiveness study examined a telephonic nursing program to translate well-validated cognitive-behavioral and motivational interviewing adherence counseling into routine clinical care. Participants were 98 PLWH who were followed for up to 6 months after recruitment from HIV care settings across the United States. Each participant received telephone counseling (Mdn =three sessions) from a trained nurse who followed up with the participant over time. Nurses assessed participants' readiness for adherence, provided support to overcome identified barriers, and offered information based on participants' questions. At 6 months after the start of treatment, a greater percentage of participants had adherence at or above 95% than expected for this population, based on a clinical interview. Self-efficacy was related to baseline medication adherence, whereas other clinical and demographic variables were not. Attrition was a concern but was unrelated to adherence, self-efficacy, or clinical severity measures. Telephone counseling was associated with a relatively high percentage of participants reaching target antiretroviral therapy adherence levels and may be an effective method to disseminate psychologically based counseling into a broad range of care settings.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active / psychology
  • Directive Counseling / organization & administration*
  • Female
  • Follow-Up Studies
  • HIV Infections* / drug therapy
  • HIV Infections* / nursing
  • HIV Infections* / psychology
  • Humans
  • Male
  • Medication Adherence* / psychology
  • Medication Adherence* / statistics & numerical data
  • Middle Aged
  • Motivation
  • Nursing Evaluation Research
  • Patient Education as Topic
  • Program Evaluation
  • Self Efficacy
  • Social Support
  • Surveys and Questionnaires
  • Telenursing / organization & administration*
  • Telephone
  • United States