English title dissertation | Treatment Adherence, Health Related Quality of Life and Aging in HIV-1 infected patients |
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Name PhD (surname first) | Langebeek, Nienke |
Doctor is (has been) nurse | |
Date of promotion | 08/06/2017 |
University | Universiteit van Amsterdam |
Promotores | Promotoren: prof. dr. M.A.G. Sprangers & prof. dr. P. Reiss. Copromotor: dr. P.T. Nieuwkerk |
Abstract (English) | A meta-analysis on predictors and correlates of adherence to cART showed that adherence was most strongly associated with patients’ adherence-related beliefs. It suggest several potential options for interventions to improve adherence. One intervention, simplification of therapy to a fixed-dose was perceived to be more convenient, and resulted in improved adherence. There is no golden standard to measure adherence. A combination of methods were compared including EMD, diaries, self-reports, physician and nurse assessments, pill-counts, pharmacy refill, in-depth-interviews and TDM. The conclusion was that patient’s self-reports, the estimation by nurse and the combination with TDM are easy to implement and can be used successfully in daily practice. Another meta-analysis was carry out to assess the effectiveness of EMD combined with informed counselling. The contribution of just monitoring-informed counselling to improve levels of adherence and virological treatment response is difficult to establish. It reflects that adherence is a behaviour that may be affected by a multitude of factors addressed by multi-component interventions. The age of HIV-1 infected adults increasing and therefore the onset of age-associated co-morbidities increases which may negatively affect HRQL. |
Download dissertation (English) | Proefschrift-Langebeek-N.pdf |