The Role of the Home Environment and Routinization in ART Adherence

Published In: Journal of the International Association of Physicians in AIDS Care, v. 10, no. 3, May/June 2011, p. 176-182

Posted on RAND.org on April 20, 2011

by Christine Anne Vaughan, Glenn Wagner, Lisa Kraus, Gery W. Ryan, James Scott

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Previous research suggests that routinization of medication-taking behavior promotes antiretroviral therapy (ART) adherence. The current study explored the nature of medication-taking routines in the home environment, where medication is most often taken, to identify home-based cues for taking ART. Qualitative interviews were conducted in the homes of 31 HIV-positive adult males in the United States with varying levels of adherence problems. Interviews were audiotaped and transcribed. Content analysis was performed to elicit themes from the text and further categorize responses. Patients with more routinized medication-taking behavior reported fewer adherence problems. Home-based medication-taking triggers that were especially common among patients who reported fewer adherence problems included meals, pillboxes, time of day, and visual cues. Findings characterize the nature of home-based medication-taking routines and suggest the potential utility of the home environment as a setting for adherence interventions.

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