Preferencias, satisfacción y adherencia con el tratamientoantirretroviral: estudio ARPAS (II) / No disponible

Objetivo: Describir el estudio ARPAS y analizar las características sociodemográficas, clínicas y las preferencias de los pacientes con el tratamiento antirretroviral (TAR), así como la relación entrela adherencia y la satisfacción con el TAR y la calidad de vida.Método: El estudio ARPAS ha evaluado a pacientes adultos,diagnosticados de infección por VIH y con TAR, mediante un protocolo que incluye variables sociodemográficas, clínicas, terapéuticas y de calidad de vida. La adherencia se estimó mediante el cuestionarioSMAQ, la satisfacción mediante el cuestionario ESTAR, la calidad de vida mediante el MOS-HIV y las preferencias con el tratamiento se determinaron mediante un cuestionario elaborado a partir del consenso de un equipo experto en el seguimiento terapéutico de estospacientes. Se realizó un análisis univariante estratificado en funciónde la adherencia y un análisis de regresión logística para estudiar la asociación de las variables independientes con la adherencia.Resultados: Se evaluaron 234 pacientes (73,7% varones;43,2 ± 7,8 años). El tiempo medio desde el diagnóstico y desde el inicio del TAR fue, respectivamente, de 10,1 ± 5,7 y 7,4 ± 4,4 años. El régimen terapéutico de dos tomas diarias (bid) se dio en el 71% de los pacientes, y el de una toma (qd) en el 21%. El 47,3% de los pacientes cumplieron criterios de adherencia según el SMAQ. El porcentaje de los pacientes con qd adherentes alTAR fue mayor que el resto de esquemas posológicos (55,3 vs. 45,1%), aunque no significativamente (p = 0,251). No se observaron diferencias en las variables sociodemográficas y clínicas en función de la adherencia. Se observó una preferencia electivasobre los regímenes terapéuticos más sencillos que contrasta con la valoración de las características de los TAR, donde se antepone la potencia sobre la durabilidad, tolerancia y, en último lugar, comodidad de tomar el TAR. El análisis univariante muestra unamayor puntuación en las escalas de satisfacción (50,4 ± 7,8 vs.46,5 ± 9,7, p = 0,001) y calidad de vida (81,6 ± 10,7 vs. 75,7 ± 11,8, p < 0,001) en los pacientes adherentes respecto de los no adherentes. Los modelos multivariante confirman la existencia de una asociación significativa entre adherencia y satisfacción, y adherencia y calidad de vida.Conclusiones: Los pacientes consideran prioritario tratarse con un TAR potente, duradero y bien tolerado y, dentro de las preferencias entre las diferentes pautas, destacan los regímenes de una toma diaria. El estudio ARPAS demuestra la relación directa entre adherencia y satisfacción con el TAR, y entre adherencia y calidad de vida, de forma que las estrategias de mejora de la adherencia deben incluir necesariamente aspectos que permitan mejorar la satisfacción del paciente con su tratamiento e incrementarla calidad de vida

Objective: To describe the ARPAS study and analyse thesociodemographic and clinical characteristics and patient preferenceswith regards the antiretroviral treatment (ART), as well as the relationship between compliance and satisfaction with the ART and quality of life.Method: The ARPAS study has looked at adult patients diagnosed with HIV and on ART, using a protocol including sociodemographic, clinical, therapeutic and quality of life variables. Compliance was estimated using the SMAQ questionnaire; satisfactionwas measured using the ESTAR questionnaire, as was quality of life with the MOS-HIV Health Survey, and treatment preferences were determined using a questionnaire prepared based on the consensus of an expert team in the field of therapeutic monitoringof these patients. A stratified univariate analysis according to compliance and a logistic regression analysis were carried out to study the association of the independent variables with compliance.Results: A total of 234 patients were evaluated (73.7% male; 43.2 ± 7.8 years of age). The average time since diagnosis and from the initiation of ART was 10.1 ± 5.7 and 7.4 ± 4.4 years respectively.The therapeutic regime of twice-daily doses (bid) wasapplied to 71% of the patients, and once daily (qd) in 21%. A total of 43% of the patients fulfilled compliance criteria according to the SMAQ. The percentage of the patients with qd complying with theART was greater than the remaining dosing schedules (55.3 vs. 45.1%), although not significantly (p = 0.251). No differences were observed in the sociodemographic and clinical variables in terms ofcompliance. An elective preference was observed for the simplest of the therapeutic regimes which contrasts with the evaluation of the ART characteristics, where power is given preference over durability,tolerance and lastly, the convenience of taking the ART. The univariate analysis showed the highest score on the satisfaction scales (50.4 ± 7.8 vs. 46.5 ± 9.7, p = 0.001) and quality of life (81.6± 10.7 vs. 75.7 ± 11.8, p < 0.001) in compliant patients with respect to non-compliers. The multivariate models confirm the existence of a significant association between compliance and satisfaction, and between compliance and quality of life.Conclusions: Patients consider treatment with a powerful,long-lasting and well-tolerated ART a priority and among their preferences for different treatment regimes, once-daily dosing regimes are highlighted. The ARPAS study showed a direct relationship between compliance and satisfaction with ART, and between complianceand quality of life, in a manner that the strategies improving compliance must necessarily include aspects that allow them to improve patient satisfaction with treatment and quality of life

[Preferences, satisfaction and compliance with antiretroviral treatment: ARPAS study (II)]. / Preferencias, satisfacción y adherencia con el tratamiento antirretroviral: estudio ARPAS (II).

OBJECTIVE: To describe the ARPAS study and analyse the sociodemographic and clinical characteristics and patient preferences with regards the antiretroviral treatment (ART), as well as the relationship between compliance and satisfaction with the ART and quality of life. METHOD: The ARPAS study has looked at adult patients diagnosed with HIV and on ART, using a protocol including sociodemographic, clinical, therapeutic and quality of life variables. Compliance was estimated using the SMAQ questionnaire; satisfaction was measured using the ESTAR questionnaire, as was quality of life with the MOS-HIV Health Survey, and treatment preferences were determined using a questionnaire prepared based on the consensus of an expert team in the field of therapeutic monitoring of these patients. A stratified univariate analysis according to compliance and a logistic regression analysis were carried out to study the association of the independent variables with compliance. RESULTS: A total of 234 patients were evaluated (73.7% male; 43.2+/-7.8 years of age). The average time since diagnosis and from the initiation of ART was 10.1+/-5.7 and 7.4+/-4.4 years respectively. The therapeutic regime of twice-daily doses (bid) was applied to 71% of the patients, and once daily (qd) in 21%. A total of 43% of the patients fulfilled compliance criteria according to the SMAQ. The percentage of the patients with qd complying with the ART was greater than the remaining dosing schedules (55.3 vs. 45.1%), although not significantly (p=0.251). No differences were observed in the sociodemographic and clinical variables in terms of compliance. An elective preference was observed for the simplest of the therapeutic regimes which contrasts with the evaluation of the ART characteristics, where power is given preference over durability, tolerance and lastly, the convenience of taking the ART. The univariate analysis showed the highest score on the satisfaction scales (50.4+/-7.8 vs. 46.5+/-9.7, p=0.001) and quality of life (81.6+/-10.7 vs. 75.7+/-11.8, p<0.001) in compliant patients with respect to non-compliers. The multivariate models confirm the existence of a significant association between compliance and satisfaction, and between compliance and quality of life. CONCLUSIONS: Patients consider treatment with a powerful, long-lasting and well-tolerated ART a priority and among their preferences for different treatment regimes, once-daily dosing regimes are highlighted. The ARPAS study showed a direct relationship between compliance and satisfaction with ART, and between compliance and quality of life, in a manner that the strategies improving compliance must necessarily include aspects that allow them to improve patient satisfaction with treatment and quality of life.