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Standard Care Impact on Effects of Highly Active Antiretroviral Therapy Adherence Interventions: A Meta-analysis of Randomized Controlled Trials
Open accessAbstract
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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Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence
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BackgroundMethodResultInfluentialTen-year trends in antiretroviral therapy persistence among US Medicaid beneficiaries
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“The results demonstrate that variability and underreporting of comparators This study was designed to be a large-scale, more rigorously conducted confirmatory study of a prior small-scale meta-analysis we conducted in the area of HIV treatment behaviours [6].”
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“…ART adherence is attracting considerable activity, and several meta-analyses suggest interventions can improve adherence (Amico et al., 2006; de Bruin et al., 2010; Simoni, Pearson, Pantalone, Marks, & Crepaz, 2006), but there is less consistent evidence of an effect on viral load (Simoni et…”
BackgroundJeffares, I., Merriman, N. A., Rohde, D., McLoughlin, A., Scally, B., Doyle, F., Horgan, F., & Hickey, A. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2019.1641850 · Cited by 18
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The Psychosocial and Clinical Well-Being of Women Living with Human Immunodeficiency Virus/AIDS
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Vestjens, L., Kempen, G. I. J. M., Crutzen, R., Kok, G., & Zijlstra, G. A. R. (2015) · Health Education Research · doi:10.1093/her/cyv003 · Cited by 21
“The manual and proposed methods were partly based on studies of De Bruin, Viechtbauer, Hospers, Schaalma and Kok [28] and De Bruin, Viechtbauer, Schaalma, Kok, Abraham and Hospers [29] and an extensive taxonomy of 93 BCTs (BCTTv1) obtained from several consensus exercises involving an international and interdisciplina…”
MethodHauger, S., Borgen, I., Løvstad, M., Lu, J., Forslund, M., Kleffelgård, I., Andelic, N., & Røe, C. (2022) · The journal of head trauma rehabilitation · doi:10.1097/htr.0000000000000765 · Cited by 11
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Uusküla, A., Laisaar, K., Raag, M., Lemsalu, L., Lõhmus, L., Rüütel, K., Amico, K. R., Zilmer, K., Aug, T., Kase, K., et al. (2017) · Aids and Behavior · doi:10.1007/s10461-017-1859-6 · Cited by 16
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“Treatment as Usual TAU adherence support was comprised of 1-on-1 nurse-support of medium to high standard compared with meta-analyses on this topic [26, 32, 33].”
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“Researchers may have concerns about characterising and clearly defining usual care because doing so could improve its quality and content, which in turn could reduce the effect size of the intervention [43].”
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“We tailored further by using the taxonomy of Abraham and Michie(46,47) and the coding manual by de Bruin to categorize the behavior change techniques that required to be enclosed in the intervention.(46,48) For each of the components of HBM, the determinants, techniques, and application strategy that were developed ar…”
MethodWolfe, P. S., Wertalik, J. L., Monaco, S. D., & Gardner, S. J. (2019) · Sexuality and Disability · doi:10.1007/s11195-019-09585-4 · Cited by 12
Medication adherence across the lifespan: Theory, methods, interventions and six grand challenges
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“This includes poor reporting, coding and analysis of control or treatment as usual conditions (de Bruin et al., 2010; Oberjé, Dima, Pijnappel, Prins, & de Bruin, 2015).”
de Bruin, M., Dima, A. L., Texier, N., & Ganse, E. H. V. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.04.039 · Cited by 12
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“Adherence rates of 95% or greater are widely regarded as optimal to achieve virologic suppression and derive immunological benefits, but more than half of antiretroviral therapy patients are unable to sustain these levels (de Bruin et al., 2010).”
BackgroundCommunication Between HIV Patients and Their Providers: A Qualitative Preference Match Analysis
Mulder, B. C., van Lelyveld, M. A. A., Vervoort, S. C. J. M., Lokhorst, A. M., van Woerkum, C. M. J., Prins, J. M., & de Bruin, M. (2014) · Health Communication · doi:10.1080/10410236.2014.933017 · Cited by 10
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“…and de-emphasising the comparison between intervention and control, recognising that control groups often receive active intervention content (e.g., Albarracín et al., 2005; de Bruin et al., 2010; Lennon, Huedo-Medina, Gerwien, & Johnson, 2012; Tan, Huedo-Medina, Warren, Carey, & Johnson, 2012).”
BackgroundUn Modelo Psicológico de Adhesión en Personas VIH+: Modelamiento con Ecuaciones Estructurales
Piña, J. A., & González, M. T. (2010) · Revista Iberoamericana de Psicología y Salud · doi:10.70478/rips.2010.01.14 · Cited by 9
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“Control group support can explain differences in outcome not only between different interventions but also between different control groups (de Bruin et al., 2010; Black et al., 2020).”
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“This information would at a minimum enable us to better estimate the ‘real’ efficacy of psychological interventions, and in future meta-analyses we would also be able to control for this variability.(13) An important but different avenue to pursue is to keep working on strategies to optimise uptake in CR (and psycholo…”
BackgroundKalichman, S. C., Katner, H. P., Eaton, L. A., Banas, E., Hill, M., & Kalichman, M. O. (2020) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaa109 · Cited by 8
“The checklist included 20 adherence support services that have been identified in past research describing the standard of care in HIV adherence services [30].”
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“Adherence rates of 95 percent or greater are widely regarded as optimal to achieve virologic suppression and derive immunological benefits, but more than half of antiretroviral therapy patients are unable to sustain these levels (De Bruin et al., 2010).”
BackgroundOberjé, E. J. M., de Bruin, M., Evers, S., Viechtbauer, W., Nobel, H., Schaalma, H. P., McCambridge, J., Gras, L. A., Tousset, E., & Prins, J. M. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-274 · Cited by 7
“For the rationale behind the intervention, please see de Bruin et al., 2005; 2010 [18,31].”
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“The sub scales were based on the coding taxonomy provided by the original author: knowledge, awareness, attitude, social influence, self-efficacy, intention formation, action control, facilitation, metascore [29].”
MethodResultAuthentic leadership at the Cleveland Clinic: psychological safety in the midst of crisis
Porter, T. H., Peck, J. A., Bolwell, B. J., & Stoller, J. K. (2023) · BMJ Leader · doi:10.1136/leader-2022-000626 · Cited by 4
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Does Managed Problem Solving Work and in What Setting?
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Assessing Implicit Cognition Among Patients Lost to Follow-up for HIV Care: A Preliminary Study
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“While ART requires adherence rates of 95% or higher for a patient to achieve immunological benefits and virologic suppression [12, 13], research indicates that more than half of patients are unable to meet these stringent standards [14, 15].”
BackgroundHealth Promotion and Health Education: Improving Patients’ Health Status
Sassen, B. (2017) · Springer eBooks · doi:10.1007/978-3-319-51769-8_4 · Cited by 3
Availability of Training Programmes on Sexuality for Adolescents with Severe Disabilities: A Review
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“comparators may obscure results from meta-analyses of SPI trials [8, 18].”
ResultSocial Determinants of HIV Health Care: A Tale of Two Cities
Doshi, R., Rio, C. D., & Marconi, V. (2011) · InTech eBooks · doi:10.5772/19352 · Cited by 4
Adherence to HIV Treatment as Prevention and Preexposure Prophylaxis
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“The earlier studies demonstrated that the use of theory-based approaches can facilitate the e ff ective implementation of interventions in behavior changes (de Bruin et al., 2010; Peters et al., 2013; van Achterberg et al., 2011).”
Javornik, N., Powell, D., Eisma, M. C., Johnston, M., Campbell, M., Hartmann‐Boyce, J., Michie, S., West, R., Black, N., & de Bruin, M. (2022) · Psychology and Health · doi:10.1080/08870446.2022.2081688 · Cited by 1
“The checklist showed a high internal consistency (α = .91) and authors’ responses predicted differences in health behaviour and clinical outcomes in comparators, as well as in trial effect sizes (i.e. predictive validity; de Bruin et al., 2009; 2010).”
BackgroundResultInfluentialSanders, J., Glynn, T. R., Mayo, D., Dale, S. K., Harkness, A., & Safren, S. A. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03849-5 · Cited by 1
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“Previous research has shown that low‐ quality reporting of comparator groups can bias effect size estimates and mislead interpretation (Dawson et al. 2009; de Bruin 2010; Freedland et al. 2011).”
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Influencing HIV treatment success in India : do mobile phones really work?
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Participants’ Perceptions of an HIV/AIDS Workshop
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Commentary on “Communication Strategies to Improve HIV Treatment Adherence” by Rochon et al. (2011)
de Bruin, M. (2011) · Health Communication · doi:10.1080/10410236.2011.616630
“Yet, when all these study results were pooled in meta-analyses, it became clear that the high HIV treatment success rates could be largely attributed to the impact of patient-centered, high-quality adherence counseling programs in standard clinical care and in the experimental interventions ( de Bruin, Viechtbauer, Ho…”
Antiretroviral Adherence Interventions: What Works and What Does not Work
Chung, M. H. (2011) · Future Virology · doi:10.2217/fvl.11.100
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Plourde, N. (2021) · uO Research (University of Ottawa) · doi:10.20381/ruor-27134
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Intervention Mapping Step 4: Designing the Self-Management and/or Lifestyle Intervention
Sassen, B. (2023) · Springer eBooks · doi:10.1007/978-3-031-11255-3_15
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777956
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777953
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777950
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777959
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777944
Bendtsen, M., Åsberg, K., & McCambridge, J. (2022) · Figshare · doi:10.6084/m9.figshare.19777962
HIV-infected childbearing women in Europe: health, treatment and care
Bailey, H. (2013) · UCL Discovery (University College London)
Metadata
- 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)
- 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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