Adherence: Keeping up with your meds

May 2008     View PDF     En español

Building a support network for yourself

Setting up a good relationship with your doctor is critical for maintaining your adherence. Your doctor should know the current standards of care for treating HIV. He or she should spend time with you to fully explain the benefits and the challenges of treatment.

If you decide to start treatment, it’s important to clarify your regimen with your doctor. Knowing what drugs you’re taking and why will help you better understand the importance of adherence. One survey showed that the vast majority of people were unclear of their regimens only ten minutes after talking with their doctors. Some understood the dose but were confused about diet restrictions. Others were unclear on the correct doses or the timing of them.

A useful way to understand your treatment regimen is writing down instructions and repeating them back to your doctor. You can check them again with your pharmacist when you pick up or order the drugs. Use the team approach. Your doctor, nurse, pharmacist and other providers can help you start and maintain effective therapy.

Since adjusting your diet can be difficult at first, it’s important to know what and when you can and cannot eat. Just as important, try to understand exactly what is meant by the drug’s diet requirements. For example, many people interpret them for Crixivan (indinavir) to mean that it should not be taken with food, which can be difficult for many people. The actual requirement is that it shouldn’t be taken with fatty foods. Light snacks and non-fat foods can be taken with the drug without concern.

Similarly, the requirements for Viracept (nelfinavir) are often thought to mean that it must be taken with food. In fact, the label says only that it should be taken with food. In some cases, there’s a genuine medical need to take a drug with or without food. In other cases, like for Videx (didanosine, ddI), taking it with food is recommended only to lessen its side effects or unpleasant aftertaste.

Some researchers note that people who foster friendly and supportive relationships with medical office staff get better service from them. Bringing another person — a family member, friend or advo­cate — to appointments ensures that two people can ask questions and get information.

Ask your doctor to be clear about side effects how to manage them. Being mentally prepared for side effects can make them easier to manage if they occur. Make a plan with your doctor around what to do if you experience a difficult side effect. Knowing that you will have timely contact with a doctor may reassure you that side effects will be managed well.

It is also important to find out what to do if you miss a dose. If you do miss one, ask your doctor how you should handle it — if you should make it up or just take the next scheduled one at the usual time. Also, note the missed dose and the reason for missing it. There may be a strategy you can use to avoid missing a future dose.

If you’re unable to take all the drugs in your regimen, don’t take a partial dose. Contact your doctor immediately if you can’t take your full dose for whatever reason. In this situation it might be necessary for you to stop all of your HIV drugs until you’re able to take a complete dose in the regimen again.

Planning

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