Premium
Switching from a two‐tablet regimen of tenofovir/emtricitabine and efavirenz to a one‐tablet regimen may affect patients’ perceptions and drug management
Author(s) -
Rotzinger A,
Locatelli I,
Bug O,
Fayet Mello A,
Parienti JJ,
Cavassini M,
Schneider M.P
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12345
Subject(s) - medicine , efavirenz , emtricitabine , regimen , tenofovir , affect (linguistics) , pharmacology , drug , human immunodeficiency virus (hiv) , family medicine , antiretroviral therapy , viral load , linguistics , philosophy
Objectives Simplification of antiretroviral therapy enhances a patient's adherence but a new formulation could also lead to new adverse events and changes in daily routine. This study compared medication adherence, tolerance and satisfaction among subjects switching from a two‐tablet tenofovir/emtricitabine/efavirenz regimen to a one‐tablet regimen. Methods Clinical and sociodemographic data were collected and three surveys were administered at month 0 (=switch), and then 1 and 4–6 months after the switch: the Beliefs about Medicines Questionnaire, the HIV ‐symptom index questionnaire, the Short HIV Treatment Satisfaction Questionnaire, the Swiss HIV Cohort Study ( SHCS ) two‐item adherence questionnaire, and a questionnaire on daily combination antiretroviral therapy ( cART ) management. Medication adherence of a subgroup of subjects was routinely monitored using an electronic device ( MEMS ™ ). Results Eighty‐eight subjects gave informed consent to participate in the study. The subjects’ back‐switch rate was 7% (six of 88). Subjects who did not back‐switch preferred the one‐tablet regimen (median = 2; IQR = 1.3–2.5; on a −3 to 3 scale), but no change in adherence was found (10 of 46 nonadherent subjects; P = 1.00). The perception of treatment necessity score decreased ( P = 0.004), the efavirenz blood level increased (14%; P = 0.04), and association/dissociation of cART with food intake evolved ( P = 0.01) after the switch. Subjects listed equivalent numbers of symptoms during the three visits. Conclusions The one‐tablet regimen was preferred but the number of back‐switches was not negligible. The perception of treatment necessity score decreased with the simplification of the regimen from a two‐tablet to a one‐tablet formulation, which could negatively impact adherence. Switching is a sensitive time in a patient's treatment life and professionals should pay particular attention to patient's perceptions of treatment during such a transition.