You Are Here    Clinical Guidelines   Archived Guidelines   Adherence (2001)   Appendix 1

Appendix 1

Topics to be covered for patients commencing a new antiretroviral regimen

Explanation of HAART

  • how HAART works
  • patient-specific rationale for starting HAART now, which takes account of the patient's own beliefs about treatment
  • goals of HAART
  • role of CD4 and viral load testing
  • how to monitor HAART

Adherence

  • what is adherence
  • why it is important
  • how drug resistance occurs
  • the relationship between adherence and resistance, and treatment failure
  • the impact of resistance on future options
  • target adherence levels
  • what to do if doses are missed, delayed, or vomited
  • what to do if stopping therapy

Psychosocial Assessment

  • assess motivation, beliefs and attitudes towards medication and adherence
  • assessment of behavioural skills necessary for adherence (goal-setting, time-tabling, assertiveness/communication, problem-solving, etc.)
  • assessment of behavioural determinants of adherence (daily routine, e.g. eating, sleeping and working patterns; recreational activities; familial/social relationships and responsibilities; travel plans, etc.)
  • assessment of social factors relevant to adherence (relationship status, accommodation, financial resources, etc.)
  • assessment of psychological disorders (depression, anxiety, etc.)

Medication History

  • prescription medicines
  • non-prescription (over-the-counter) medicines
  • herbal, traditional medicines
  • recreational drug and alcohol use
  • previous allergies or intolerances, adherence difficulties and strategies
  • swallowing difficulties, i.e. can you take a pill or are liquids preferred?

Side-effects

  • acute
  • chronic/long-term

Explanation of HAART

  • how HAART works
  • patient-specific rationale for starting HAART now, which takes account of the patient's own beliefs about treatment
  • goals of HAART
  • role of CD4 and viral load testing
  • how to monitor HAART

Adherence

  • what is adherence
  • why it is important
  • how drug resistance occurs
  • the relationship between adherence and resistance, and treatment failure
  • the impact of resistance on future options
  • target adherence levels
  • what to do if doses are missed, delayed, or vomited
  • what to do if stopping therapy

Psychosocial Assessment

  • assess motivation, beliefs and attitudes towards medication and adherence
  • assessment of behavioural skills necessary for adherence (goal-setting, time-tabling, assertiveness/communication, problem-solving, etc.)
  • assessment of behavioural determinants of adherence (daily routine, e.g. eating, sleeping and working patterns; recreational activities; familial/social relationships and responsibilities; travel plans, etc.)
  • assessment of social factors relevant to adherence (relationship status, accommodation, financial resources, etc.)
  • assessment of psychological disorders (depression, anxiety, etc.)

Medication History

  • prescription medicines
  • non-prescription (over-the-counter) medicines
  • herbal, traditional medicines
  • recreational drug and alcohol use
  • previous allergies or intolerances, adherence difficulties and strategies
  • swallowing difficulties, i.e. can you take a pill or are liquids preferred?

Side-effects

  • acute
  • chronic/long-term