Pillbox Organizers Can Help Maintain Antiretroviral Regimen Adherence, Slow Progression of HIV to AIDS, Study Says

HIV-positive people who use pillbox organizers to help adhere to their antiretroviral drug regimens could reduce the risk of progressing to AIDS, according to a study published in the October issue of the journal Clinical Infectious Diseases, Reuters Health reports.

For the study, David Bangsberg of San Francisco General Hospital and colleagues followed 245 HIV-positive people from 1996 to 2000. The researchers periodically tracked the participants' adherence to their antiretroviral regimens by conducting unannounced pill counts every three to six weeks. All study participants were taking a minimum of three different medications.

The researchers used three statistical models to compare adherence for individuals who chose to use pillbox organizers and those who did not. Sixty-one percent of the study participants used the organizers for at least one month during the course of the study. The researchers found that pillbox users increased their adherence to prescribed drug regimens by up to 4.5%. They also had substantially lower levels of HIV in their blood and were nearly twice as likely to have a viral load of 400 virus copies per milliliter or less. Pillbox users also were 11% less likely than nonusers to progress to AIDS during the course of the study.

Conclusions
"Pillbox organizers should be a standard intervention to improve adherence to antiretroviral therapy," the researchers wrote, adding that people living with HIV who do not fully adhere to prescribed regimens increase their risk of developing drug resistance, progressing to AIDS and death. The researchers acknowledged that antiretroviral regimens are simpler now than when the study was conducted, so it is unclear whether pillbox organizers would be as helpful for patients today. However, they added that "given the simplicity and low cost of the intervention, clinicians should consider including pillbox organizers in their routine treatment of chronic disease" (Reuters Health, 9/12).

The study abstract is available online.