Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG Adherence Instruments

This paper describes the AACTG Adherence Instruments, which are comprised o f two self-report questionnaires for use in clinical trials conducted by th e Adult AIDS Clinical Trials Group (AACTG). The questionnaires were adminis tered to 75 patients at ten AACTG sites in the USA. All patients were takin g combination antiretroviral therapy (ART), including at least one protease inhibitor. Eleven per cent of patients reported missing at least one dose the day before the interview, and 17% reported missing at least one dose du ring the two days prior. The most common reasons for missing medications in cluded 'simply forgot' (66%) and a number of factors often associated with improved health, including being busy (53%), away from home (57%) and chang es in routine (51%). Less adherent patients reported lower adherence self-e fficacy (p = 0.006) and were less sure of the link between non-adherence an d the development of drug resistance (p = 0.009). They were also more likel y to consume alcohol, to be employed outside the home for pay and to have e nrolled in clinical trials to gain access to drugs (all p < 0.05). Twenty-t wo per cent of patients taking drugs requiring special instructions were un aware of these instructions. Each questionnaire took approximately ten minu tes to complete. Responses to the questionnaires were favourable. These que stionnaires have been included in six AACTG clinical trials to date and hav e been widely disseminated to investigators both in the USA and abroad.