Reader Remarks on:

When Your Patient Is Too Busy to Take Meds

Depression and Once-Daily Dose
Patients too burdened to take ARVs

Depression and Once-Daily Dose

Alexandre Naime Barbosa, Fac Medicina Unesp, 19 May 2009 8:09 AM EST

Competing interests: None declared

I think that the most important point is to prescribe a easy combination, like Once-Daily Dose, associated to a good aproach at the possibility of depression.

Patients too burdened to take ARVs

OLAYINKA. A OLASODE, OBAFEMI AWOLOWO UNIVERSITY, ILE IFE, 14 Jun 2009 5:40 AM EST

Competing interests: None declared

We have the same scenario in our practice as well as some patients stopping medications on religious convictions that they are healed, Effective counselling is required. I would really want to re establish the confidence in this patient and create a workable partnership with her for her therapy. Issues of barrier to adherence would be addressed. Usually we take such patients through a fresh ART adherence training programme which is patient participatory. being part of her management team helps. I will commence Pneumocystis jirovecii pneumonia (PCP) prophylaxis immediately before antiretroviral therapy (ART). A two dose regime is appropriate here tenofovir (300 mg once daily) + AZT (300 mg twice daily) + a boosted PI. Social issues need to be addressed. I will encourage her to be in support group. Studies show better adherence in patients in support groups versus those who are not.

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