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Once-Daily Pills Improve Outcomes

November/December 2012

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People taking only one pill daily for their HIV treatment had less hospitalization and greater adherence than those taking multiple pills.

Those findings were presented by Cal Cohen, M.D., of the Community Research Initiative of New England, in Boston. He and his colleagues looked at data from Medicaid claims since once-daily single tablet regimens (STRs) have become available.

Previously, other studies found that STRs improved adherence -- taking medication as prescribed (every day, with or without food, etc.). Adherence is especially important in HIV treatment because the virus can mutate around missed or incorrectly taken medications, making therapy ineffective in the process.

Of nearly 8,000 patients prescribed HIV therapy, 1,838 were given an STR and 5,945 were given a multiple-pill regimen. The people on STRs had a 25% lower risk of hospitalization and 14 fewer hospitalizations per 100 patients. Women of child-bearing age on STRs and men with a previously diagnosed mental disorder taking STRs also had less hospitalization. The differences were statistically significant, even after taking other things into consideration, such as being on therapy for the first time (when results tend to be the best).

The study poster noted that the higher adherence achieved with STRs may have contributed to these results. It also noted that because this was a cohort study (looking at an existing group) instead of a randomized one (where patients are matched as equally as possible and then divided into the treatments being examined), there may be confounding factors in the results.

The study also found that, as with all prescription drugs, some people prescribed an STR just wouldn't take it -- about 10% of all HIV drug prescriptions, STR or not, went unfilled.


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