importance of Adhering to Your Treatment Regimen
of the most important things to think about before beginning
treatment for HIV disease is your ability to take the
treatments properly. This is called "treatment
adherence," and it may sound easy, but sometimes
it's not. Studies show that even doctors have enormous
difficulty taking even short-term drug regimens strictly
according to the rules.
far as we know, anti-HIV medicine has to be taken for
life. Not taking the medicine properly can lead to "drug
resistance," where HIV mutates and becomes resistant
to a drugs effect. This in turn leads to treatment failure.
Therefore, it's important to plan adherence strategies
should raise questions about treatment adherence with
your doctor when you're deciding what treatments to
take. Different drugs have different rules - some drugs
may be taken only once a day, while others must be taken
with a high-fat meal. Because you will probably be taking
several different medications, each drug may have different
rules. It's importance to know which drug goes with
do I need to know to ensure good adherence?
many pills of each different medicine are you supposed
to take at a time?
many times a day are you supposed to take each medicine,
when do you take them?
are the food requirements for each different medicine?
should you do if you forget a dose?
a drug regimen that works with you schedule will help
to improve your adherence. For instance, if you're often
travelling from place to place in the middle of the
day, then a drug that involves a dose in the middle
of the day may give you problems. If you tend to eat
at different times each day, then drugs with strict
requirements about eating may give you a problem.
you are considering different treatment regimens, plan
out schedules that include the things you regularly
do - such as taking your kids to school, going to work,
or eating a late dinner - and then think about how different
drug regimens might affect that schedule. For instance,
let's compare two different treatment regimens.
+ Crixivan + Videx EC + Zerit
up, take Videx on empty stomach & 1 hour before
take Norvir, Crixivan, and Zerit
break, take combivir with a snack
take Norvir, Crixican, and Zerit
Combivir and Sustiva, go to bed
can see from these schedules how different drug regimens
have different effects on your day.
there a way to prepare for a complicated drug regimen?
if you're not sure you can handle a drug regimen with
a complicated schedule, it might be wise to practice
a little first before starting the actual drugs.
might sound silly, but you might try to use jellybeans
first! Think of it as an experiment to see if you can
adhere to a treatment regimen. For instance, a bag of
red jellybeans might represent Videx and would be taken
once a day on an empty stomach. A bag of blue jellybeans
might represent Zerit, and would be taken twice a day
with or without food. A bag of green jellybeans might
represent viracept, and you'd take give green jellybeans
twice a day, with a meal or a light snack.
following the jellybeans regimen for a week or two,
you can find out whether or not the schedule works for
you. You can also spot potential problems times, and
try to find solutions. That way, when you actually start
the medicines, you've already taken important steps
to change your schedule.
you think you're ready to start taking a new drug regimen,
make sure to ask your doctor any questions you still
have before she or he writes the prescriptions. One
of the biggest problems with adherence is doctors who
don't communicate enough information. Make your doctor
write down the instructions for taking your medication,
and read them back to her or him. It can be easy to
confuse "two pills three time a day" with
"three pills two times a day", so it's important
to be sure that you understand how many pills you're
supposed to take, and how many times a day you take
important thing to know is that the times that you take
the drugs are important. In other words, if your doctor
says to take a drug every twelve hours or every eight
hours, then it's important to stick pretty close to
that schedule. Taking medicine properly prevents drugs
resistance - the longer you wait to take a dose, the
less there is of the previous dose in your system to
fight HIV and drug resistance.
all sounds to difficult, Is there an easier way?
just common sense, but it's important to know that there
are studies showing that simpler treatment regimens
are easier to adhere to than more complicated regimens.
In other words, a drug regimen that involves fewer pills
taken fewer times during the day may be easier to take
properly than a drug regimen that involves lots of different
pills taken may times a day.
you don't think you can stick to a proposed drug regimen,
then don't start it. Ask your doctor about the possibility
of taking an easier regimen instead. Either way, you
shouldn't start therapy until you are ready. Starting
a treatment regiment that you are very ill, it might
be better to wait until you're ready and able, or until
easier treatment regimens become available.
I've started treatment, are there tools to help me stay
There are a number of tools you can use to help you
remember your doses. For some people, a schedule on
their refrigerator reminds them to take their medicine.
Others rely on electronic pillboxes this beep at the
appropriate time. Or how about a digital watch with
about creative ways to remind yourself to take your
medicine when you're supposed to take it. It also helps
to recruit family and friends to help you remember.
Encourage the people around you to ask, "Did you
take your medicine today?" Lets face it - moral
support is important!