Date of Award

2003

Degree Type

Thesis

Degree Name

Master of Science in Applied Pharmaceutical Sciences

Department

Applied Pharmaceutical Sciences

First Advisor

Cynthia Willey

Abstract

Title of the Study: Health-related quality of life (HRQoL) as predictor of medication adherence in patients infected with Human Immune-deficiency Virus (HIV).

Summary: Quality of life (QoL) is a broad term which involves evaluation of all aspects of life including, health, education, family life, housing, friendship, marriage, standard of living, and work. Health is one of the domains that affect our quality of life. The measurement of HRQoL is becoming an increasingly common activity in healthcare systems around the world. Health-related quality of life or biological outcome of treatment might predict adherence to HIV medication. This research is aimed to study the effect of HRQoL on medication adherence in patients infected with HIV. The original study was funded by NIH and conducted by Dr. Cynthia Willey, at University of Rhode Island during the years 1995-98. The purpose of the original project was to assess the stages of changes for adherence with HIV-Related Medications. The sample consisted of 145 patients. The questionnaire was developed by AIDS Clinical Trial Group (AACTG). Questionnaires were distributed to the patients in Rhode Island at different sites affiliated with Brown University AIDS program. These sites included:

  1. The Miriam Hospital Immunology Center: This center serves majority of the HIV positive women in Rhode Island.
  2. Stanley Street Treatment and Resources: This center serves the Greater Fall River Massachusetts area and provides care to indigent and intravenous drug users.
  3. Veteran Affairs Medical Center in Providence, RI: This center treats approximately 60 HIV positive men.

Methodology: The data was collected by administering a standardized selfreported questionnaire to the subjects to assess the compliance to HIV drugs. The questionnaire covered various aspects like, Demographic, Economic status, Coping, Quality of life, Medication, etc. Four domains of health-related quality of life were measured using 12 questions based on SF-36 included in the questionnaire. Medication adherence was assessed as self-reported adherence and also using Medication Adherence Scale. Univariate and bivariate tests were run to check for confounding variables in the data set. Logistic regression was used to determine any interaction between independent variables. The effect of Quality of life domains on medication adherence were assessed by running logistic regression model after controlling for potential confounding factors.

Results: The results of this study indicate that "vitality/fatigue" is significantly associated with 95% self-reported adherence in patients taking protease inhibitors. This study thus confirms that patients with better mental health are more likely to adhere to their medication regimen. This is consistent with previous findings by other researchers. No other meaningful association was found between any other domain of QoL and medication adherence.

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