Definition of adherence:
The standard clinical definition of adherence has been taking more than 95% of medications the right way, at the right time. Over time, this definition has been broadened to include more factors related to continuous care, such as following a care plan, attending scheduled clinic appointments, picking up medicines on time and getting regular CD4 tests.
Adherence describes how faithfully a person sticks to and participates in her or his HIV prevention, care and treatment plan.
Adherence:
- Includes active participation of the client in her or his care plan
- Includes adherence to both medications and care
- Depends on a shared decision-making process between the client and health care providers
- Determines the success of HIV care and treatment programs
- Is not static – it changes over time
Adherence to care includes:
- Entering into and continuing on a care and treatment plan
- Taking medicines to prevent and treat opportunistic infections
- Participating in ongoing education and counseling
- Attending appointments and tests, such as regular CD4 tests, as scheduled
- Picking up medications when scheduled and before running out
- Recognizing when there is a problem or a change in health and coming to the clinic for care and support
- Adopting a healthy lifestyle and trying to avoid risky behaviors
Adherence to treatment includes:
- Taking ARVs correctly, as prescribed, for the person’s whole life, even if the person feels healthy (“every pill, every day”)
- Taking other medicines, such as CTX, as prescribed
- Not taking any treatment “breaks”
- Giving medications to HIV-exposed and HIV-infected babies and children as prescribed
Non-adherence includes:
- Missing one or many appointments at the hospital or health center, lab or pharmacy
- Not following the care plan
- Missing a dose or doses of medicine
- Sharing medications with other people
- Stopping medicine for a day or many days, or taking a treatment break or holiday
- Taking medicines at the wrong times
- Taking medicines without following instructions about food or diet
- Not reducing risk-taking behavior (for example, not practicing safer sex or not delivering a baby with a trained health care provider)
References
- The Comprehensive Peer Educator Training Curriculum: Trainer Manual International Center for AIDS Care and Treatment Programs, Columbia University