Cited by 181HIV/AIDS Research and InterventionsMedication Adherence and ComplianceHIV/AIDS drug development and treatment

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Standard Care Impact on Effects of Highly Active Antiretroviral Therapy Adherence Interventions: A Meta-analysis of Randomized Controlled Trials

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de Bruin, Marijn·2010·Archives of Internal Medicine

DOI 10.1001/archinternmed.2009.536

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Abstract

BACKGROUND: Poor adherence to medication limits the effectiveness of treatment for human immunodeficiency virus. Systematic reviews can identify practical and effective interventions. Meta-analyses that control for variability in standard care provided to control groups may produce more accurate estimates of intervention effects. METHODS: To examine whether viral load and adherence success rates could be accurately explained by the active content of highly active antiretroviral therapy (HAART) adherence interventions when controlling for variability in care delivered to controls, databases were searched for randomized controlled trials of HAART adherence interventions published from 1996 to January 2009. A total of 1342 records were retrieved, and 52 articles were examined in detail. Directly observed therapy and interventions targeting specific patient groups (ie, psychiatric or addicted patients, patients <18 years) were excluded, yielding a final sample of 31 trials. Two coders independently retrieved study details. Authors were contacted to complete missing data. RESULTS: Twenty studies were included in the analyses. The content of adherence care provided to control and intervention groups predicted viral load and adherence success rates in both conditions (P < .001 for all comparisons), with an estimated impact of optimal adherence care of 55 percentage points. After controlling for variability in care provided to controls, the capacity of the interventions accurately predicted viral load and adherence effect sizes (R(2) = 0.78, P = .02; R(2) = 0.28, P < .01). Although interventions were generally beneficial, their effectiveness reduced noticeably with increasing levels of standard care. CONCLUSIONS: Intervention and control patients were exposed to effective adherence care. Future meta-analyses of (behavior change) interventions should control for variability in care delivered to active controls. Clinical practice may be best served by implementing current best practice.

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Vrijens, B., Urquhart, J., & White, D. (2014) · Expert Review of Clinical Pharmacology · doi:10.1586/17512433.2014.940896 · Cited by 52
“• There is a large variability in SOC, making it difficult to compare healthcare providers or care sites [52].”
Background
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis
Kahwati, L. C., Viswanathan, M., Golin, C. E., Kane, H., Lewis, M. A., & Jacobs, S. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0255-z · Cited by 53
“If the proportion of studies within a truth table row demonstrating improved adherence is above the specified consistency threshold (80 % in our analysis), the Table 1 Behavior change techniques (BCTs) used in interventions to improve medication adherence [14, 15]”
Method
Feasibility of Real Time Medication Monitoring Among HIV Infected and TB Patients in a Resource-Limited Setting
de Sumari-de Boer, I. M., van den Boogaard, J., Ngowi, K. M., Semvua, H. H., Kiwango, K. W., Aarnoutse, R. E., Nieuwkerk, P. T., & Kibiki, G. S. (2016) · AIDS and Behavior · doi:10.1007/s10461-015-1254-0 · Cited by 40
“As multiple factors may influence adherence such as patient-, treatment-, socioeconomic- and healthcare system- related factors [3, 12, 13, 15, 28, 37, 43, 45, 47, 50, 54], interventions should preferably target multiple factors instead of a single factor.”
Background
Using qualitative comparative analysis in a systematic review of a complex intervention
Kahwati, L. C., Jacobs, S., Kane, H., Lewis, M. A., Viswanathan, M., & Golin, C. E. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0256-y · Cited by 50
“Interventions to improve adherence often involve combinations of behavior change techniques (BCTs), such as interventions to improve self-efficacy or change attitudes.”
MethodInfluential
Risk of bias in trial-based economic evaluations: Identification of sources and bias-reducing strategies
Evers, S., Hiligsmann, M., & Adarkwah, C. C. (2014) · Psychology and Health · doi:10.1080/08870446.2014.953532 · Cited by 53
“The problem is that care as usual is often not defined (Ayling, Brierley, Johnson, Heller, & Eiser, 2015; Bishop, Fenge-Davies, Kirby, & Geraghty, 2015; de Bruin, Viechtbauer, Hospers, Schaalma, & Kok, 2009; de Bruin et al., 2010) and this comparator can differ from country to country.”
Background
Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta‐analysis
Black, N., Eisma, M. C., Viechtbauer, W., Johnston, M., West, R., Hartmann‐Boyce, J., Michie, S., & de Bruin, M. (2020) · Addiction · doi:10.1111/add.14969 · Cited by 47
Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: Results from a randomized trial
Peltzer, K., Ramlagan, S., Jones, D. L., Weiss, S. M., Fomundam, H., & Chanetsa, L. (2012) · SAHARA-J Journal of Social Aspects of HIV/AIDS · doi:10.1080/17290376.2012.745640 · Cited by 45
Cost Effectiveness of Medication Adherence-Enhancing Interventions: A Systematic Review of Trial-Based Economic Evaluations
Oberjé, E. J. M., de Kinderen, R. J. A., Evers, S., van Woerkum, C. M. J., & de Bruin, M. (2013) · PharmacoEconomics · doi:10.1007/s40273-013-0108-8 · Cited by 44
“Intervention components were usually described in some detail (although usually insufficient to allow replication), but details on the usual care provided to control groups were missing from all papers, in spite of evidence suggesting that the quality of usual care may vary considerably between study sites and have an…”
Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists
Timmers, L., Boons, C. C. L. M., Verbrugghe, M., van den Bemt, B. J. F., Hecke, A. V., & Hugtenburg, J. G. (2017) · BMC Cancer · doi:10.1186/s12885-017-3110-2 · Cited by 44
Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: a systematic review
Okafor, U., Crutzen, R., Aduak, Y., Adebajo, S. B., & van den Borne, H. W. (2017) · African Journal of AIDS Research · doi:10.2989/16085906.2017.1358753 · Cited by 41
“Consistent with the three RCT studies and supported by existing literature, effects can only be seen if the intervention uses activities that are not yet part of the standard intervention in the control group (de Bruin et al., 2010).”
Result
Adherence to imatinib therapy in patients with gastrointestinal stromal tumors
Blay, J., & Rutkowski, P. L. (2013) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2013.07.005 · Cited by 43
“90–95% adherence) [36].”
Intensity of Treatment as Usual and Its Impact on the Effects of Face-to-Face and Internet-Based Psychotherapy for Depression: A Preregistered Meta-Analysis of Randomized Controlled Trials
Münder, T., Geisshüsler, A., Krieger, T., Zimmermann, J., Wolf, M., Berger, T., & Watzke, B. (2022) · Psychotherapy and Psychosomatics · doi:10.1159/000521951 · Cited by 44
Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing CEssation (IC-SMOKE) interventions: a systematic review protocol
de Bruin, M., Viechtbauer, W., Eisma, M. C., Hartmann-Boyce, J., West, R., Bull, E., Michie, S., & Johnston, M. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0253-1 · Cited by 41
Understanding usual care in randomised controlled trials of complex interventions: a multi-method approach
Yorganci, E., Evans, C. J., Johnson, H., Barclay, S., Murtagh, F. E., Yi, D., Gao, W., Pickles, A., & Koffman, J. (2020) · Palliative Medicine · doi:10.1177/0269216320905064 · Cited by 40
Effects of Behavioral Intervention Content on HIV Prevention Outcomes: A Meta-Review of Meta-Analyses
Johnson, B. T., Michie, S., & Snyder, L. B. (2014) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000235 · Cited by 40
Overview of systematic reviews on strategies to improve treatment initiation, adherence to antiretroviral therapy and retention in care for people living with HIV: part 1
Mbuagbaw, L. C. E., Hajizadeh, A., Wang, A. R., Mertz, D., Lawson, D. O., Smieja, M., Benoit, A. C., Álvarez, E., Ritchie, L. M. P., Rachlis, B., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-034793 · Cited by 40
Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · BMC Medicine · doi:10.1186/s12916-022-02374-5 · Cited by 39
Risk of bias in randomised controlled trials of health behaviour change interventions: Evidence, practices and challenges
de Bruin, M. (2015) · Psychology & Health · doi:10.1080/08870446.2014.960653 · Cited by 36
Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals: a systematic review of randomised controlled trials
Power, B., Kiezebrink, K., Allan, J., & Campbell, M. (2014) · BMC Obesity · doi:10.1186/s40608-014-0023-3 · Cited by 35
Virtual Intervention to Support Self-Management of Antiretroviral Therapy Among People Living With HIV
Côté, J., Godin, G., Ramirez-Garcìa, P., Rouleau, G., Bourbonnais, A., Guéhéneuc, Y., Tremblay, C. L., & Otis, J. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3264 · Cited by 35
“Also, the meta-analysis by de Bruin and colleagues [25] showed that standard adherence care (traditional follow-up) had a large impact on HIV treatment effectiveness and adherence.”
Do interventions containing risk messages increase risk appraisal and the subsequent vaccination intentions and uptake? – A systematic review and meta‐analysis
Parsons, J., Newby, K. V., & French, D. (2018) · British Journal of Health Psychology · doi:10.1111/bjhp.12340 · Cited by 34
Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study
Waters, L., George, A. S., Chey, T., & Bauman, A. E. (2012) · BMC Medical Research Methodology · doi:10.1186/1471-2288-12-120 · Cited by 34
“Favourable behaviour changes among control group participants have been observed for a diverse range of other health behaviours [7-9].”
BackgroundInfluential
Trends in medication adherence in HIV patients in the US , 2001 to 2012: an observational cohort study
Youn, B., Shireman, T. I., Lee, Y., Galárraga, O., & Wilson, I. B. (2019) · Journal of the International AIDS Society · doi:10.1002/jia2.25382 · Cited by 29
Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes: Systematic Review and Meta-Analysis
Zomahoun, H. T. V., de Bruin, M., Guillaumie, L., Moisan, J., Grégoire, J., Pérez, N., Vézina‐Im, L., & Guénette, L. (2015) · Value in Health · doi:10.1016/j.jval.2015.02.017 · Cited by 30
Assessing Usual Care in Clinical Trials
Erlen, J. A., Tamres, L. K., Reynolds, N. R., Golin, C. E., Rosen, M. I., Remien, R. H., Banderas, J., Schneiderman, N., Wagner, G. J., Bangsberg, D. R., et al. (2014) · Western Journal of Nursing Research · doi:10.1177/0193945914526001 · Cited by 28
“When usual care is based on the latest evidence, it may include components that are also within the behavioral intervention that is being tested in the trial such as health teaching to promote better medication management (de Bruin et al., 2010).”
Evidence for Technology Interventions to Promote ART Adherence in Adult Populations: a Review of the Literature 2012–2015
Amico, K. R. (2015) · Current HIV/AIDS Reports · doi:10.1007/s11904-015-0286-4 · Cited by 30
Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence
Ownby, R. L., Waldrop‐Valverde, D., Jacobs, R. J., Acevedo, A., & Caballero, J. (2013) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-13-29 · Cited by 32
“Interventions for adherence are clearly a part of standard care for HIV infection [9] and it is likely that standard interventions may have a positive effect on patients ’ adherence [10].”
Background
Brief interventions to prevent sexually transmitted infections suitable for in-service use: A systematic review
Long, L., Abraham, C., Paquette, R., Shahmanesh, M., Llewellyn, C. D., Townsend, A. F., & Gilson, R. J. C. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.06.038 · Cited by 28
“by variations in usual care control conditions and that such variations are rarely described across trials (46).”
Hybrid Systematic Review and Network Meta-Analysis of Randomized Controlled Trials of Interventions for Depressive Symptoms in Patients With Coronary Artery Disease
Doyle, F., Freedland, K. E., Carney, R. M., de Jonge, P., Dickens, C. M., Pedersen, S. S., Sørensen, J. R., & Dempster, M. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000944 · Cited by 27
Long-Term Effects of Psychological Interventions to Improve Adherence to Antiretroviral Treatment in HIV-Infected Persons: A Systematic Review and Meta-Analysis
Locher, C., Messerli, M., Gaab, J., & Gerger, H. (2019) · AIDS Patient Care and STDs · doi:10.1089/apc.2018.0164 · Cited by 28
“63,64 As we used just two characteristics of usual care as potential moderators in our meta-regressions, we cannot rule out that other characteristics of the implementation of usual care may impact outcome.”
HIV-Infected Individuals Who Delay, Decline, or Discontinue Antiretroviral Therapy: Comparing Clinic- and Peer-Recruited Cohorts
Gwadz, M. V., Applegate, E., Cleland, C. M., Leonard, N. R., Wolfe, H. E., Salomon, N., Belkin, M., Riedel, M., Banfield, A., Sanfilippo, L., et al. (2014) · Frontiers in Public Health · doi:10.3389/fpubh.2014.00081 · Cited by 27
A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process
Sassen, B., Kok, G., Mesters, I., Crutzen, R., Cremers, A., & Vanhees, L. (2012) · JMIR Research Protocols · doi:10.2196/resprot.1804 · Cited by 26
Reactions to threatening health messages
ten Hoor, G. A., Peters, G.-J., Kalagi, J., de Groot, L., Grootjans, K., Huschens, A., Köhninger, C., Kölgen, L., Pelssers, I., Schütt, T., et al. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-1011 · Cited by 26
“They suggest that when communicating with professionals, it seems fruitful to provide them with a toolbox of evidence-based behaviour change methods that promote adaptive, rather than defensive, behaviour [39-42].”
Background
Assessing treatment motivation among patients receiving antiretroviral therapy: A multidimensional approach
Houston, E., McKirnan, D. J., Cervone, D., Johnson, M., & Sandfort, T. G. M. (2011) · Psychology and Health · doi:10.1080/08870446.2011.618536 · Cited by 25
“Estimates indicate that approximately 50% of patients fail to consistently meet these high standards (de Bruin et al, 2010 ).”
BackgroundInfluential
Reducing Alcohol Consumption Among Risky Drinkers in the General Population of Sweden Using an Interactive Mobile Health Intervention: Protocol for a Randomized Controlled Trial
Bendtsen, M., & McCambridge, J. (2019) · JMIR Research Protocols · doi:10.2196/13119 · Cited by 25
Planning for influenza vaccination in health care workers: An Intervention Mapping approach
Kok, G., van Essen, G. A., Wicker, S., Llupià, A., Mena, G., Correia, R., & Ruiter, R. A. C. (2011) · Vaccine · doi:10.1016/j.vaccine.2011.09.008 · Cited by 24
Doing patient-centredness versus achieving public health targets: A critical review of interactional dilemmas in ART adherence support
de Kok, B. C., Widdicombe, S., Pilnick, A., & Laurier, É. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.03.030 · Cited by 25
Determinants of Engagement in HIV Treatment and Care Among Zambians New to Antiretroviral Therapy
Jones, D. L., Zulu, I., Vamos, S., Cook, R., Chitalu, N. W., & Weiss, S. M. (2012) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2012.06.009 · Cited by 23
“However, failure to maintain gains in adherence may be associated with study design, such as variability in standard of care (de Bruin et al., 2010); poor outcomes have been obtained in numerous ARV adherence studies (Simoni, Amico, Pearson, & Malow, 2008).”
Result
A systematic review and meta-analysis of interventions incorporating behaviour change techniques to promote breastfeeding among postpartum women
Kassianos, A. P., Ward, E., Rojas‐García, A., Kurti, A. N., Mitchell, F., Nostikasari, D., Payton, J., Pascal-Saadi, J., Spears, C. A., & Notley, C. J. (2019) · Health Psychology Review · doi:10.1080/17437199.2019.1618724 · Cited by 25
“…application (absence, partial application, consistent application), acknowledging contextual and co-occurrence factors and coding whether BCTs occurred uniquely in the control group (de Bruin et al., 2010; de Bruin, Viechtbauer, Hospers, Schaalma, & Kok, 2009; Peters, De Bruin, & Crutzen, 2015).”
Background
Using the behaviour change technique taxonomy v1 (BCTTv1) to identify the active ingredients of pharmacist interventions to improve non-hospitalised patient health outcomes
Scott, C., de Barra, M., Johnston, M., de Bruin, M., SCOTT, N. W., Matheson, C., Bond, C. M., & Watson, M. C. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036500 · Cited by 24
Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives
Houston, E., Osborn, A., Lyons, T. P., Masvawure, T. B., & Raja, S. (2015) · Journal of Community & Applied Social Psychology · doi:10.1002/casp.2228 · Cited by 24
Importance of the nature of comparison conditions for testing theory-based interventions: Reply.
Michie, S., Prestwich, A., & de Bruin, M. (2010) · Health Psychology · doi:10.1037/a0020844 · Cited by 23
Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD) Project
Been, S. K., van de Vijver, D. A. M. C., Nieuwkerk, P. T., Brito, I., Stutterheim, S. E., Bos, A. E. R., Wolfers, M. E. G., Pogány, K., & Verbon, A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0162800 · Cited by 21
“Interventions seeking to improve adherence should subsequently be evaluated for effect, while controlling for variability in the standard of care provided to control groups as this can influence the effect sizes of behavior change interventions [33, 34].”
Background
The Role of Emotional Avoidance, the Patient–Provider Relationship, and Other Social Support in ART Adherence for HIV+ Individuals
Berghoff, C. R., Gratz, K. L., Portz, K. J., Pinkston, M. M., Naifeh, J. A., Evans, S. D., Konkle‐Parker, D. J., & Tull, M. T. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1745-2 · Cited by 21
STUDY PROTOCOL: EXPOSURE IN VIRTUAL REALITY FOR SOCIAL ANXIETY DISORDER - a randomized controlled superiority trial comparing cognitive behavioral therapy with virtual reality based exposure to cognitive behavioral therapy with in vivo exposure
Clemmensen, L., Bouchard, S., Rasmussen, J., Holmberg, T. T., Nielsen, J. H., Jepsen, J. R. M., & Lichtenstein, M. B. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-2453-4 · Cited by 26
Triggered Escalating Real-Time Adherence Intervention to Promote Rapid HIV Viral Suppression Among Youth Living With HIV Failing Antiretroviral Therapy: Protocol for a Triggered Escalating Real-Time Adherence Intervention
Amico, K. R., Dunlap, A., Dallas, R., Lindsey, J. C., Heckman, B., Flynn, P., Lee, S., Horvath, K. J., Goolsby, R. W., Hudgens, M. G., et al. (2019) · JMIR Research Protocols · doi:10.2196/11416 · Cited by 14
Effects of integrated interventions on transmission risk and care continuum outcomes in persons living with HIV
Crepaz, N., Baack, B. N., Higa, D. H., & Mullins, M. M. (2015) · AIDS · doi:10.1097/qad.0000000000000879 · Cited by 20

Authors: de Bruin, M.
Venue: Archives of Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2010-02-08
Volume: 170
Issue: 3
Pages: 240
ISSN: 0003-9926 (ISSN-L)
DOI: 10.1001/archinternmed.2009.536
OpenAlex: W2167947569
Cited by: 181
References: 84
Citations by year: 2026: 2 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 12 · 2021: 8 · 2020: 8 · 2019: 12 · 2018: 11 · 2017: 13 · 2016: 12 · 2015: 14 · 2014: 27 · 2013: 21 · 2012: 16
FWCI: 2.00
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Archives of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, other-oa)
Socio-Environmental Systems Modeling (acceptedVersion)
Lirias (submittedVersion, cc-by)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
Keywords: HIV, antiretroviral therapy, medication adherence, adherence interventions, standard of care, viral load, randomized controlled trials
MeSH terms: HIV, Humans, Patient Compliance, HIV Infections, Randomized Controlled Trials as Topic, Treatment Outcome, Antiretroviral Therapy, Highly Active

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Standard Care Impact on Effects of Highly Active Antiretroviral Therapy Adherence Interventions: A Meta-analysis of Randomized Controlled Trials

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