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Adherence question.
Jan 23, 2006

Dear Doctor; Please Define in detail the term "100% ADHERENCE" for those of us unsure.

Regards.

Response from Dr. Sherer

My definition of 100% adherence would be that a person has taken each and every dose of medication as prescribed.

HIV doctors are in the difficult position of having to advise their patients to be 'perfect' when it comes to adherence, though we know that people are not perfect. So we are really urging them to be as near perfect as possible, in order to get the best possible benefit from these medications.

The newer ART regimens have the advantage of being somewhat 'forgiving', which is also a useful term to define. "Forgiving" in this context means able to make up - to some extent - for the fact that people are not perfect. Regimens with boosted PIs and with efavirenz or nevirapine have the advantage of high drug levels that may allow a late dose occassionally, or even a missed dose, though I would never encourage a patient to miss a single dose.

I hope that's helpful. Don't forget to ask your doctor what he or she means by 100% adherence as well.


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