Power Point Presentation medical writing sample.

1. The Problem of Nonadherence
Initial Results with Diabetes and Hypertensive Patients
Initial Results with HIV/AIDS Drugs
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2. The risk of virologic failure rises with

noncompliance (N=161 HIV-infected women)*
17% virologic failure with 88% or greater compliance with

drug regimen
 72% virologic failure with 12% or less compliance
Predictors of nonadherence to regimen

Active drug use, alcohol use

 More frequent antiretroviral dosing
Improving long-term adherence in women should

be a public health priority
*Howard AA, et al. AIDS. 2002;16:2175-82.
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3. Suboptimal adherence is a strong predictor of

treatment failure
Inconvenient treatment regimens are factors

associated with poor adherence
Frank I, JAIDS. 2002;31:S10–S15
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4. Frank I, JAIDS. 2002;31:S10–S15
3/29/2009 4

5. OD Therapy Improves Adherence

Adherence indices rates were 60.5% in the OD cohort

(n = 746) and 52% in the BID cohort (n = 246)
 At 12 months, these dropped to 44.4% (OD) and
35.8% (BID)
Dezii DM, et al. South Med J. 2002;95(1):68-71.
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6. Methods such as drug regimen simplification
1.
should be aggressively sought to improve
adherence.
Improved adherence rates may be achieved with a
2.
once-daily regimen despite a higher pill burden.
Once-daily pharmacotherapy results in higher
3.
adherence and persistence with therapy compared
with a twice-daily regimen.
Dezii DM, et al. South Med J. 2002;95(1):68-71.
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7. Overall compliance was 98.9% with OD

therapy, and 97.5% with BID therapy (n = 133)
2.6% missed doses in the OD group, and 3.3%

missed doses in the BID group
Blood pressure normalized (<140 mm Hg

systolic and <90 mm Hg diastolic) in 41% of the
OD patients and 27% of the BID patients
Andrejak M, et al. Am J Hypertens. 2000;13:184–190.
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8. Patients (n = 69) with viral loads of <50 HIV-1

RNA copies/mL were switched after 2 years of
therapy on BID saquinavir soft-gelatin capsules
(SQV-SGC) (1400 mg) plus zidovudine/
lamivudine or didanosine/stavudine to OD
SQV-SGC/RTV (1600/100 mg) with continuing
nucleoside reverse transcriptase inhibitors
(NRTIs).
Cardiello PG, et al. JAIDS. 2002;29:464–470.
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9. 93% (n = 64) had plasma viral loads of <50

copies/mL 24 weeks after switching regimens
5 patients had plasma viral loads of <300 copies/mL

Median CD4 cell count increased from 534/mL

to 695/mL in the 24 weeks (p < .001) since
switching to OD treatment
Cardiello PG, et al. JAIDS. 2002;29:464–470.
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10. The data suggests that the combination of SQV-

SGC/RTV (1600/100 mg) once daily plus two
NRTIs may be a realistic option to
simplify PI-containing therapy and

 improve compliance in a select group of HIV-1–
infected patients with plasma viral loads of <50
copies/mL.
Cardiello PG, et al. JAIDS. 2002;29:464–470.
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11. Adherence remains one of the greatest

challenges for patients receiving antiretroviral
treatment
Increased simplification of treatment regimens

should assist in improving the long-term
adherence to therapy and maintaining
treatment efficacy
Frank I, JAIDS. 2002;31:S10–S15.
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12. In the future, once-daily regimens will become

the standard of care for HIV infection
Several currently available antiretroviral drugs

can be used once daily, or

 have the pharmacokinetic potential for once-daily
dosing, and
 others are in development
Frank I, JAIDS. 2002;31:S10–S15.
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13. 1. Gifford AL, Bormann JE, Shively MJ, Wright, BC, Richman DD, Bozzette SA: Predictors of self-
reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral
regimens. JAIDS. 2000;23:386–395.
2. Howard AA, Arnsten JH, Yungtai L,Vlahov D, et al; for HER Study Group. A prospective
study of adherence and viral load in a large multi-center cohort of HIV-infected women. AIDS.
2002;16:2175–2182.
3. Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes
in patients with HIV infection. Ann Intern Med. 2000;133:21–30.
4. Mannerheimer S, Friedland G, Matts J, et al. Self-reported antiretroviral adherence correlates
with HIV viral load and declines over time [abstract TuOrB421]. Abstract presented at the XIII
International AIDS Conference; Durban, South Africa; July 9–14, 2000; Abstracts-On-Disk, XIII
International AIDS Conference [CD-ROM] published by Merck Sharp & Dohme.
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14. 5. Dezii CM, Kawabata H, Tran M: Effects of once-daily and twice-daily dosing on adherence
with prescribed glipizide oral therapy for type 2 diabetes. South Med J. 2002;95(1):68-71.
6. Andrejak M. Electronic Pill-Boxes in the Evaluation of Antihypertensive Treatment
Compliance: Comparison of Once Daily Versus Twice Daily Regimen. Am J Hypertens.
2000;13:184–190.
7. Cardiello PG, et al. Simplifying protease inhibitor therapy with once-daily dosing of saquinavir
soft-gelatin capsules/ritonavir (1600/100 mg): HIVNAT 001.3 study. JAIDS. 2002;29:464–470.
8. Frank I. Once-daily HAART: toward a new treatment paradigm. JAIDS. 2002;31:S10–S15.
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