Publication Abstract Display
Type: Published Manuscript
Title: Memory-based adherence strategies for antiretroviral medication management in HIV: An evaluation of clinical predictors, adherence behavior awareness, and effectiveness.
Authors: Blackstone K, Woods SP, Weber E, Grant I, Moore DJ, and the HNRP Group
Year: 2013
Publication: AIDS and Behavior
Volume: 17 Issue: 1 Pages: 74-85
Abstract:"Forgetting" is the most commonly endorsed reason for missing an antiretroviral therapy (ART) dose among HIV-infected individuals, but we know little about the prevalence, predictors, and effectiveness of the mnemonic strategies to support ART adherence that are commonly recommended by clinical psychologists. The frequency and perceived effectiveness of 28 self-reported memory-based medication strategies was assessed with the Prospective Memory for Medications Questionnaire in 233 HIVinfected individuals. Thirty-day ART adherence was measured via the Medication Event Monitoring System. HIV-infected individuals employed multiple (8.7±5.6) strategies with the most common being internally-driven (e.g., "read medication instructions more than once"). More frequent overall strategy use was uniquely associated with increased affective distress, dependence in everyday functioning, and non-ART pill burden, as well as poorer 30-day ART adherence, but not neurocognitive deficits or perceived effectiveness of strategy use. Individuals who used strategies frequently, but perceived them as minimally effective, had more affective, physical, and functional distress. HIV-infected individuals employ multiple, primarily internally-based mnemonic strategies for ART management, which were most common among individuals with comorbid nonadherence risk factors (i.e., higher pill burden, affective and functional distress). More frequent strategy use was associated with worse ART adherence and was not related to perceived effectiveness. Primary reliance on internally-based mnemonic strategies may reflect a meta-functional deficit (i.e., limited cognitive insight into adherence behavior) and may be insufficient to support optimal ART adherence in vulnerable populations.

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