Adhering to Your
Treatment Regimen
Healthy LivingWith HIV www.patientedu.org/hiv
T
here have been many advances in HIV treatment over the past few decades. These have led to the emergence of effective drug combinations, which can help many people control their HIV and live longer, healthier lives. In order for HIV drugs to do their job properly, you need to do your part. That means taking your drugs exactly as they are prescribed. To do so, it requires taking the right amount of drugs at the right times. It also means keeping in mind any food or medication restrictions. Adhering to an HIV drug treatment regimen can be challenging because it’s a daily, lifelong commitment. Learning about effective ways to improve your ability to adhere to your treatment regimen is well worth the effort. This brochure is intended to tell you about adherence and why it matters for people living with HIV. It will tell you about ways to improve your ability to adhere to your treatment regimen.
What Is Treatment Adherence? The term “treatment adherence” means to follow your treatment regimen. This means taking the correct dose of each anti-HIV drug at the correct time and exactly how it was prescribed. This means finding out if there are any food or medication restrictions to keep in mind each time you take a particular drug. Adherence is an important part of HIV care that can help you get the most out of your treatments.
the body, or the viral load. Skipping medications—even occasionally—gives HIV a chance to multiply rapidly. Preventing the virus from multiplying is the best way to stay healthy. Second, good adherence to an HIV treatment regimen helps prevent drug resistance. Drug resistance develops when the virus mutates, meaning it changes its form. This makes it “resistant” to certain anti-HIV drugs. One or more anti-HIV drugs in a treatment regimen can become ineffective as a result of drug resistance. Skipping medications makes it easier for drug resistance to develop. HIV can develop resistance to the anti-HIV drugs in a person’s current regimen or to other, similar anti-HIV drugs that you may not have taken yet. This can limit the options for successful HIV treatment. Making matters worse is that drug-resistant strains of HIV can be transmitted to others. There are many different anti-HIV drugs and treatment regimens that your healthcare provider and you will discuss before starting anything. However, studies show that your first regimen usually offers the best chance for long-term treatment success. Adhering to your regimen from the start will help ensure your HIV treatment is successful.
Why Adherence Matters Adherence affects the success of HIV treatment in two ways. First, good adherence to an HIV treatment regimen helps anti-HIV drugs work effectively to reduce the amount of HIV in
2
3
T
here have been many advances in HIV treatment over the past few decades. These have led to the emergence of effective drug combinations, which can help many people control their HIV and live longer, healthier lives. In order for HIV drugs to do their job properly, you need to do your part. That means taking your drugs exactly as they are prescribed. To do so, it requires taking the right amount of drugs at the right times. It also means keeping in mind any food or medication restrictions. Adhering to an HIV drug treatment regimen can be challenging because it’s a daily, lifelong commitment. Learning about effective ways to improve your ability to adhere to your treatment regimen is well worth the effort. This brochure is intended to tell you about adherence and why it matters for people living with HIV. It will tell you about ways to improve your ability to adhere to your treatment regimen.
What Is Treatment Adherence? The term “treatment adherence” means to follow your treatment regimen. This means taking the correct dose of each anti-HIV drug at the correct time and exactly how it was prescribed. This means finding out if there are any food or medication restrictions to keep in mind each time you take a particular drug. Adherence is an important part of HIV care that can help you get the most out of your treatments.
the body, or the viral load. Skipping medications—even occasionally—gives HIV a chance to multiply rapidly. Preventing the virus from multiplying is the best way to stay healthy. Second, good adherence to an HIV treatment regimen helps prevent drug resistance. Drug resistance develops when the virus mutates, meaning it changes its form. This makes it “resistant” to certain anti-HIV drugs. One or more anti-HIV drugs in a treatment regimen can become ineffective as a result of drug resistance. Skipping medications makes it easier for drug resistance to develop. HIV can develop resistance to the anti-HIV drugs in a person’s current regimen or to other, similar anti-HIV drugs that you may not have taken yet. This can limit the options for successful HIV treatment. Making matters worse is that drug-resistant strains of HIV can be transmitted to others. There are many different anti-HIV drugs and treatment regimens that your healthcare provider and you will discuss before starting anything. However, studies show that your first regimen usually offers the best chance for long-term treatment success. Adhering to your regimen from the start will help ensure your HIV treatment is successful.
Why Adherence Matters Adherence affects the success of HIV treatment in two ways. First, good adherence to an HIV treatment regimen helps anti-HIV drugs work effectively to reduce the amount of HIV in
2
3
Considering the Challenges There are many reasons why adhering to an HIV drug regimen can be difficult for those living with the virus. Most treatment regimens involve taking a lot of pills every day. Many of these pills come with strict instructions. Some can be taken only with or only without food. Some drug regimens require a specific order in which the medications can be taken.
Things to Think About Before you start treatment, be certain you’re committed to taking anti-HIV drugs every day as directed. Talk to your healthcare provider about any issues that may make it hard for you to adhere to any specific drug regimens. These include: • Possible side effects. •H ow other medications interact with your drugs. Other factors that can make treatment adherence difficult include: • Difficulty taking medications, such as trouble swallowing pills. • Side effects from medications, such as fatigue or diarrhea. •D aily schedule issues, such as a busy schedule, shift work, or travel away from home. • Being sick or depressed. • Abuse of alcohol or other drugs.
4
•Y our schedule at home, work, and/or school. •A ny personal issues (eg, depression or alcohol or drug abuse). •L ack of health insurance to pay for anti-HIV drugs. Understanding issues that can make adherence difficult will help you and your healthcare provider select the best treatment regimen for you. If needed, your healthcare provider may recommend resources to help you address these issues before you start treatment.
5
Considering the Challenges There are many reasons why adhering to an HIV drug regimen can be difficult for those living with the virus. Most treatment regimens involve taking a lot of pills every day. Many of these pills come with strict instructions. Some can be taken only with or only without food. Some drug regimens require a specific order in which the medications can be taken.
Things to Think About Before you start treatment, be certain you’re committed to taking anti-HIV drugs every day as directed. Talk to your healthcare provider about any issues that may make it hard for you to adhere to any specific drug regimens. These include: • Possible side effects. •H ow other medications interact with your drugs. Other factors that can make treatment adherence difficult include: • Difficulty taking medications, such as trouble swallowing pills. • Side effects from medications, such as fatigue or diarrhea. •D aily schedule issues, such as a busy schedule, shift work, or travel away from home. • Being sick or depressed. • Abuse of alcohol or other drugs.
4
•Y our schedule at home, work, and/or school. •A ny personal issues (eg, depression or alcohol or drug abuse). •L ack of health insurance to pay for anti-HIV drugs. Understanding issues that can make adherence difficult will help you and your healthcare provider select the best treatment regimen for you. If needed, your healthcare provider may recommend resources to help you address these issues before you start treatment.
5
Preparation Is Important
9 Ways to Maintain Adherence
Being prepared to take anti-HIV drugs every day is a first step to treatment success. Planning ahead will help you adhere to your treatment regimen when you start it.
There are a lot of different strategies that you may consider to help you adhere to your anti-HIV treatment regimens. Here are a few that may work for you:
Begin by talking to your healthcare provider. Make sure you understand why you’re starting HIV treatment and why treatment adherence is important. Discuss these important details about your treatment regimen:
1)
• Each anti-HIV medication in your regimen. • The dose of each medication. • How many pills in each dose. • When to take each medication. • How to take each medication— for example, with or without food. • Possible side effects from each medication, including serious side effects. •P ossible interactions between the anti-HIV drugs in your regimen and other medications you take. • How to store your anti-HIV drugs. Remember to store medications out of the reach of children. Also, remember that medicines can go out of date. Some need to be kept at a certain temperature.
6
2)
Use pill boxes. These boxes have separate compartments into which you can put each dose of your medicine. Some people find it helpful to fill their pill box at the start of the week so they can keep track of exactly which pills they have taken. Pill boxes might be available for free from your HIV clinic. Use a medication diary. This can help you stay on track throughout your course of treatment. Write down the name of each medication. Include the dose, number of pills to take, and when to take them. Check off each medication as you take it. Reviewing your diary will help you identify the times you’re most likely to skip medications. Use this as a tool when you go to your healthcare provider for follow-up appointments.
7
Preparation Is Important
9 Ways to Maintain Adherence
Being prepared to take anti-HIV drugs every day is a first step to treatment success. Planning ahead will help you adhere to your treatment regimen when you start it.
There are a lot of different strategies that you may consider to help you adhere to your anti-HIV treatment regimens. Here are a few that may work for you:
Begin by talking to your healthcare provider. Make sure you understand why you’re starting HIV treatment and why treatment adherence is important. Discuss these important details about your treatment regimen:
1)
• Each anti-HIV medication in your regimen. • The dose of each medication. • How many pills in each dose. • When to take each medication. • How to take each medication— for example, with or without food. • Possible side effects from each medication, including serious side effects. •P ossible interactions between the anti-HIV drugs in your regimen and other medications you take. • How to store your anti-HIV drugs. Remember to store medications out of the reach of children. Also, remember that medicines can go out of date. Some need to be kept at a certain temperature.
6
2)
Use pill boxes. These boxes have separate compartments into which you can put each dose of your medicine. Some people find it helpful to fill their pill box at the start of the week so they can keep track of exactly which pills they have taken. Pill boxes might be available for free from your HIV clinic. Use a medication diary. This can help you stay on track throughout your course of treatment. Write down the name of each medication. Include the dose, number of pills to take, and when to take them. Check off each medication as you take it. Reviewing your diary will help you identify the times you’re most likely to skip medications. Use this as a tool when you go to your healthcare provider for follow-up appointments.
7
3)
Take your medications at the same time every day. For example, if you take your medication before you go to sleep, think about keeping your medication next to your bed.
4)
E nlist extra help. Your family members, friends, or coworkers may be able to help remind you to take your medications.
5)
K eep your medications nearby. Keep a backup supply of medications in your briefcase or purse or at work.
7)
P lan ahead. Be prepared for changes in your daily routine, including weekends and holidays. If you’re going away, be sure to pack enough medications to last the entire trip.
8)
Keep all your medical appointments. Write down the date and time of healthcare provider visits on your calendar or daily schedule. If you run low on medications before your next visit, call your healthcare provider to renew your prescriptions.
9)
Join a support group. You can get additional tips on adherence by joining others who are living with HIV in support groups. These groups may offer more helpful strategies to ensure that you’re adhering to your drug regimen.
6) Helpful Reminders. se a timer, an alarm clock, or your cell U phone alarm. This may be helpful to remind you to take your medications.
8
9
3)
Take your medications at the same time every day. For example, if you take your medication before you go to sleep, think about keeping your medication next to your bed.
4)
E nlist extra help. Your family members, friends, or coworkers may be able to help remind you to take your medications.
5)
K eep your medications nearby. Keep a backup supply of medications in your briefcase or purse or at work.
7)
P lan ahead. Be prepared for changes in your daily routine, including weekends and holidays. If you’re going away, be sure to pack enough medications to last the entire trip.
8)
Keep all your medical appointments. Write down the date and time of healthcare provider visits on your calendar or daily schedule. If you run low on medications before your next visit, call your healthcare provider to renew your prescriptions.
9)
Join a support group. You can get additional tips on adherence by joining others who are living with HIV in support groups. These groups may offer more helpful strategies to ensure that you’re adhering to your drug regimen.
6) Helpful Reminders. se a timer, an alarm clock, or your cell U phone alarm. This may be helpful to remind you to take your medications.
8
9
Getting Ready for Travel
schedule. Don’t take a double dose of a medication to make up for a missed dose.
Traveling with your HIV medications can be challenging, but being prepared before you go is important. Take enough medication with you if you are going to be away from home, even if it’s just overnight. Carry medicines in your hand luggage. This will make it easier to get to and less likely to get lost.
Whenever a medication is missed, be sure to talk to your doctor if you’re forgetting to take a lot of your doses. Help is available to support you. Or, it might be possible to change your treatment so that your medicines are easier to take.
Be sure to think about traveling to other time zones. This might mean you’ll need to change the time you take your medicines. Some people change their dosing schedule to fit in with their new time zone. Others gradually adjust the time they take their medicine so it fits in with their new time zone. Talk to your doctor before you travel to figure out what strategy is best for you. Do not take a break from treatment when you travel. Doing so can lead to potentially serious risks, including the development of drug-resistant HIV. Do not stop taking your medications without discussing this with your doctor.
Finding Support Adherence is hard work and takes a lot of commitment. A good way to overcome adherence problems is to get a support network of other people who will stay on your side. Your healthcare provider is one of the most important people in your network. It’s important that you talk openly with him or her about how to fit HIV treatment into your lifestyle at every visit. If you have questions or concerns, be sure to bring them up. Write down questions or things you want to talk about before your appointment. Tell your provider when you’re having difficulty following your regimen. Together, you can spot the reasons why you’re skipping medications.
When Medications Are Missed Unless your healthcare provider tells you otherwise, take a medication you missed as soon as you remember that you skipped it. However, if it’s almost time for the next dose of the medication, don’t take the missed dose and just continue on your regular medication
10
11
Getting Ready for Travel
schedule. Don’t take a double dose of a medication to make up for a missed dose.
Traveling with your HIV medications can be challenging, but being prepared before you go is important. Take enough medication with you if you are going to be away from home, even if it’s just overnight. Carry medicines in your hand luggage. This will make it easier to get to and less likely to get lost.
Whenever a medication is missed, be sure to talk to your doctor if you’re forgetting to take a lot of your doses. Help is available to support you. Or, it might be possible to change your treatment so that your medicines are easier to take.
Be sure to think about traveling to other time zones. This might mean you’ll need to change the time you take your medicines. Some people change their dosing schedule to fit in with their new time zone. Others gradually adjust the time they take their medicine so it fits in with their new time zone. Talk to your doctor before you travel to figure out what strategy is best for you. Do not take a break from treatment when you travel. Doing so can lead to potentially serious risks, including the development of drug-resistant HIV. Do not stop taking your medications without discussing this with your doctor.
Finding Support Adherence is hard work and takes a lot of commitment. A good way to overcome adherence problems is to get a support network of other people who will stay on your side. Your healthcare provider is one of the most important people in your network. It’s important that you talk openly with him or her about how to fit HIV treatment into your lifestyle at every visit. If you have questions or concerns, be sure to bring them up. Write down questions or things you want to talk about before your appointment. Tell your provider when you’re having difficulty following your regimen. Together, you can spot the reasons why you’re skipping medications.
When Medications Are Missed Unless your healthcare provider tells you otherwise, take a medication you missed as soon as you remember that you skipped it. However, if it’s almost time for the next dose of the medication, don’t take the missed dose and just continue on your regular medication
10
11
Remember the Big Picture
Learn More
In order for your medications to work, you need to take them according to the instructions. If you don’t, you’re putting yourself at risk for drug resistance and other problems. Take time to ensure that you understand the medications your healthcare provider has prescribed, including how many to take, when to take them, and whether you need to consider food or medication restrictions. Work with your healthcare provider to make it as easy as possible to take your medications. It’s hard to take pills every day, but remember why you are doing it.
If you still have questions, the following resources offer more information about adhering to treatment regimens for people living with HIV.
TheBody.com www.thebody.com/index/ treat/adherence.html
AIDSMap.com www.aidsmap.com/ Adherence/cat/1464
You want to give your HIV drugs the best chance of working to keep you healthy for the long haul.
AIDSInfo.nih.gov http://aidsinfo.nih. gov/contentfiles/ HIVandItsTreatment_ cbrochure_en.pdf
The Well Project
www.thewellproject.org/ en_US/Treatment_and_ Trials/Things_to_Consider/ Women_and_Adherence.jsp
12
13
Remember the Big Picture
Learn More
In order for your medications to work, you need to take them according to the instructions. If you don’t, you’re putting yourself at risk for drug resistance and other problems. Take time to ensure that you understand the medications your healthcare provider has prescribed, including how many to take, when to take them, and whether you need to consider food or medication restrictions. Work with your healthcare provider to make it as easy as possible to take your medications. It’s hard to take pills every day, but remember why you are doing it.
If you still have questions, the following resources offer more information about adhering to treatment regimens for people living with HIV.
TheBody.com www.thebody.com/index/ treat/adherence.html
AIDSMap.com www.aidsmap.com/ Adherence/cat/1464
You want to give your HIV drugs the best chance of working to keep you healthy for the long haul.
AIDSInfo.nih.gov http://aidsinfo.nih. gov/contentfiles/ HIVandItsTreatment_ cbrochure_en.pdf
The Well Project
www.thewellproject.org/ en_US/Treatment_and_ Trials/Things_to_Consider/ Women_and_Adherence.jsp
12
13
14
15
14
15
To learn more about HIV and AIDS, visit Healthy Living With HIV at: www.patientedu.org/HIV.
Brought to you by:
Healthy Living With HIV www.patientedu.org/hiv
www.patientedu.org 2127 2nd Avenue North Fort Dodge, IA 50501 service@patientedu.org
The editorial content for this brochure was developed and created solely by the Patient Education Center (PEC). The content does not necessarily represent the opinions and/or views of our advertisers. Disclaimer: The information provided in this brochure and on the PEC Web site is for informational purposes only and is not intended to provide or be a substitute for professional medical advice, diagnosis, or treatment. Neither PEC nor its affiliates or licensors guarantee the accuracy, adequacy, timeliness, or completeness of any information and are not responsible for errors or omissions in any consequences arising from the use of the information. The use of the PEC Web site is at the user’s own risk and all information contained therein is subject to change. Mention of a specific product, company, organization, Web site, or URL address, treatment, therapy, or any other topic does not imply a recommendation or endorsement by PEC, its affiliates, or its licensors.
16
Printed on 10% post-consumer recycled paper.
Š Copyright Patient Education Center
PEC-HL-SPO-H-001