Diary cards: Preliminary evaluation of an intervention tool for improving adherence to antiretroviral therapy and TB preventive therapy in people living with HIV/AIDS

Abstract

Adherence to prescribed medications is a central feature of good clinical HIV care and a key factor in determining the effectiveness of treatment. This is especially true for HIV-infected patients, on antiretroviral treatment, where adherence is strongly associated with survival. HIV-associated tuberculosis is a major and increasing health problem, especially in sub-Saharan Africa. Clinical trials have demonstrated a benefit of isoniazid preventive therapy in preventing TB among HIV-infected persons, and its use among these patients is recommended. Nearly perfect compliance seems to be indispensable to obtain the maximum benefit from highly active antiretroviral treatment and prophylactic medications. Accurately assessing non-adherence is a necessary first step towards improving adherence to active antiretroviral treatment and isoniazid preventive therapy. The introduction of diary cards is being considered as a measure of adherence and as a tool to improve adherence among HIV-infected individuals receiving antiretroviral treatment or isoniazid preventive therapy. This was a preliminary study to evaluate the effectiveness of diary cards as intervention tool for promoting adherence to antiretroviral and prophylactic TB therapy in people living with HIV/AIDS, to evaluate the diary card as a tool to measure adherence and to evaluate the feasibility and acceptability of diary cards.