Antiretroviral therapy remains a challenge for persons living with HIV, who must maintain high levels of adherence to prevent viral resistance and treatment failure. An effectiveness study by Cook and colleagues examined a telephonic nursing program to translate well-validated cognitive-behavioral and motivational interviewing adherence counseling into routine clinical care. Participants were 98 patients who were followed for up to six months after recruitment from HIV care settings across the United States. Each participant received telephone counseling (average =three sessions) from a trained nurse who followed up the participant over time. Nurses assessed participants' readiness for adherence, provided support to overcome identified barriers, and offered information based on participants' questions. At six months after the start of treatment, a greater percentage of participants had adherence at or above 95% than expected for this population, based on a clinical interview. Self-efficacy was related to baseline medication adherence, whereas other clinical and demographic variables were not. Attrition was a concern but was unrelated to adherence, self-efficacy, or clinical severity measures.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that telephone counseling was associated with a relatively high percentage of participants reaching target antiretroviral therapy adherence levels. It may be an effective method to disseminate psychologically based counseling into a broad range of care settings.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: A weakness to the study is that it only followed patients for six months. Considering the chronic nature of AIDS, patients should be followed for at least a year or longer. Still, the procedure used in the program could nicely augment self-management training for any patients regardless of their chronic condition. This is particularly true given that the nurses only made an average of three calls to patients in the six months they were involved in the study.

PF Cook et al. Telephone nurse counseling improves HIV medication adherence: an effectiveness study. Journal of the Association of Nurses in AIDS Care, 2009;20:316-325.

PF Cook et al. Telephone nurse counseling improves HIV medication adherence: an effectiveness study. Journal of the Association of Nurses in AIDS Care, 2009;20:316-325.