The Body: A Nurse-Led Adherence Strategy Improves Lives for People with HIV and Saves Money

By: Barbara Jungwirth, The Body, May 12, 2017

A nurse-delivered adherence intervention strategy improved markers of HIV, increased quality-adjusted life years (QALYs), a measure of quality and quantity of health, and saved money, a Dutch trial published in The Lancet Infectious Diseases found. Adherence measures whether people take their medications as prescribed. QALYs estimate how much longer someone could live in good health if a specific medical intervention were provided.

Researchers trained 21 nurses at seven HIV clinics across the Netherlands to deliver the Adherence-Improving s elf-Management Strategy (AIMS). They then randomized 221 people living with HIV to receive either standard adherence counseling or the AIMS intervention during routine care. Study participants had either never taken antiretroviral medications or had taken them for at least nine months and were at risk of having their virus levels rise again (viral rebound). QALYs were calculated based on data from more than 7,000 Dutch people living with HIV.

Standard counseling consisted of a patient leaflet, verbal information on the benefits of adherence and when and how to take the medication, a discussion of the patient's daily routine to determine the best adherence strategy and a telephone number to call in case of problems. At follow-up visits, the patient and nurse discussed how well the patient was doing in taking the medication as prescribed, any problems with doing so, side effects and the patient's viral load and CD4+ cell count results. Read more here.