A systematic review of treatment fatigue among HIV-infected patients prescribed antiretroviral therapy
Open accessAbstract
HIV treatment requires lifelong adherence to medication regimens that comprise inconvenient scheduling, adverse side effects, and lifestyle changes. Antiretroviral adherence and treatment fatigue have been inextricably linked. Adherence in HIV-infected populations has been well investigated; however, little is known about treatment fatigue. This review examines the current state of the literature on treatment fatigue among HIV populations and provides an overview of its etiology and potential consequences. Standard systematic research methods were used to gather published papers on treatment fatigue and HIV. Five databases were searched using PRISMA criteria. Of 1557 studies identified, 21 met the following inclusion criteria: (a) study participants were HIV-infected; (b) participants were prescribed antiretroviral medication; (c) the article referenced treatment fatigue; (d) the article was published in a peer-reviewed journal; and (e) text was available in English. Only seven articles operationally defined treatment fatigue, with three themes emerging throughout the definitions: (1) pill burden; (2) loss of desire to adhere to the regimen; and (3) nonadherence to regimens as a consequence of treatment fatigue. Based on these studies, treatment fatigue may be defined as "decreased desire and motivation to maintain vigilance in adhering to a treatment regimen among patients prescribed long-term protocols." The cause and course of treatment fatigue appear to vary by developmental stage. To date, only structured treatment interruptions have been examined as an intervention to reduce treatment fatigue in children and adults. No behavioral interventions have been developed to reduce treatment fatigue. Further, only qualitative studies have examined treatment fatigue conceptually. Studies designed to systematically assess treatment fatigue are needed. Increased understanding of the course and duration of treatment fatigue is expected to improve adherence interventions, thereby improving clinical outcomes for individuals living with HIV.
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Research on treatment burden and treatment fatigue has largely centered on health behaviors such as medication adherence and exercise compliance in patients with chronic disease.
“To date, research on treatment burden and treatment fatigue has largely centered on health behaviors such as medication adherence (Claborn et al., 2015) and exercise compliance in patients with chronic disease (Dobkin et al., 2005, 2006; Heckman et al., 2015).”
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Understanding Sustained Retention in HIV/AIDS Care and Treatment: a Synthetic Review
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- Authors
- Claborn, K. R., Meier, E., Miller, M. B., & Leffingwell, T. R.
- Affiliations
- Brown University (US)
- Oklahoma State University (US)
- Corresponding author
- Claborn, Kasey R.
- Venue
- Psychology, Health & Medicine
- Publisher
- Informa UK Limited
- Published
- 2014-08-11
- Volume
- 20
- Issue
- 3
- Pages
- 255-265
- ISSN
- 1354-8506 (ISSN-L)
- 1465-3966
- PMC
- PMC4315727
- OpenAlex
- W2080436266
- Cited by
- 166
- References
- 1
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 12 · 2023: 12 · 2022: 16 · 2021: 24 · 2020: 21 · 2019: 13 · 2018: 10 · 2017: 13 · 2016: 8 · 2015: 6 · 2014: 1
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychology Health & Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32AA007459)
- 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
- treatment fatigue, HIV infection, antiretroviral therapy, medication adherence, medication burden, treatment interruption, adherence interventions, HIV-infected children
- MeSH terms
- Humans, HIV Infections, Antiretroviral Therapy, Highly Active, Medication Adherence
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