ABSTRACT
OBJECTIVE: To analyze difficulties in achieving optimal adherence to antiretroviral therapy as perceived by pediatric patient caregivers in relation to treatment characteristics. METHODS: Design of a subjective numeric scale-based questionnaire, and its administration to caregivers of pediatric patients undergoing active antiretroviral therapy in our hospital, after verbal informed consent for interviewing. The questionnaire aimed to assess on a scale from 0 (no difficulty for adherence) to 5 (maximal difficulty) a number of treatment-related factors: a) number of drugs and dosage regimen; b) organoleptic properties of drugs; c) treatment administration; d) adverse events; and e) antiretroviral therapy effectiveness perceived by caregiver. The questionnaire was proposed to all caregivers, and was performed by a pharmacist in a private space within the pharmacy department. RESULTS: The questionnaire was administered to 28 caregivers of the 32 pediatric patients undergoing active antiretroviral therapy. The following factors were evaluated as entailing moderate difficulties: smell, deglutition, and the immediate gastrointestinal adverse effects of protease inhibitors in liquid dosage form. The only factor evaluated as entailing great difficulty was protease inhibitors flavour in the liquid dosage form. Therapy effectiveness perception was evaluated as high. CONCLUSIONS: According to the overall results from our survey, caregivers evaluated the following factors as entailing moderate to high difficulties for correct adherence: number of drugs in the antiretroviral combination, organoleptic properties (smell, taste) of protease inhibitors (PI), PI-related deglutition problems, and PI-related immediate gastrointestinal adverse events. These factors may be considered potential obstacles for adequate adherence to antiretroviral therapy in pediatric patients.
