Counselling and support were given in case of adherence difficulties and detectable HIV-1 viral load.
In cases of non-adherence to the ASP, the prescribed antimicrobial spectrum was considered overtreatment in 11% of cases (16 episodes), and insufficient in 89% (129 episodes) according ASP guideline.
In cases of inappropriate treatment adherence the interventionist will receive an intensive telephone mentoring session.
Accurately monitoring adherence to treatment with recombinant human growth hormone (r-hGH) enables appropriate intervention in cases of poor adherence.
Reports from Europe [ 3, 4], Puerto Rico [ 5], India [ 6], USA [ 7- 10], and Brazil [ 11] describe favourable maternal and neonatal outcomes, with a MTCT rate varying from 0 to 7.7%, detected in cases of poor adherence to therapy [ 10].
Many patients take multiple drugs, which may be a factor in cases of poor adherence (12), and patients may elect to take these drugs only if they have symptoms.
In case of non-adherence to the recommendations, valid arguments for deviating were observed in the majority of these cases.
In case of non-adherence when remission was absent (42.1%, 227/539), most frequently medication was not intensified when an intensification step should have been taken (34.9%, 188/539).
In case of non-adherence when remission was present (19.5%, 108/553), most frequently medication was tapered off or discontinued when it should have been continued (7.2%, 40/553) or treatment was continued when it should have been tapered off or discontinued (6.2%, 34/553).
Quality of life and other patient-related outcomes may improve regardless of therapeutic adherence or worsen in case of good adherence (for example because of treatment-induced adverse events).
2 These interventions may have particularly poor efficacy in cases of intentional non-adherence as the provision of persuasive advice may evoke further resistance to change.
