IMPACT OF ANTIRETROVIRAL DRUG FORMULATION TO ADHERENCE IN HIV-INFECTED CHILDREN IN CIPTO MANGUNKUSUMO HOSPITAL
Rizta Widyana,Dina Muktiarti,Monika Kristi Levania,Tiroy Junita,Tiroy Junita
Department of Child Health Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo Hospital
Background : A good quality of life among HIV-infected patients can be achieved by suppressing the amount of viral load by consuming antiretroviral (ARV) drugs daily. Adherence to the prescribed drugs is one of the most determining factors for optimal viral suppression. For children, ARV formulation may contribute to adherence after some complaints regarding unpleasant taste in certain drugs or inability to swallow tablets. There are not many choices of ARV drugs for children in Indonesia in the form that child-friendly such as syrup or pediatric tablet. Sometimes, the parents need to crush an adult tablet for these children. This study aimed to assess the impact of drug formulation (crushed tablet or pediatric tablet) to adherence among HIV-infected children in Cipto Mangunkusumo Hospital.
Material : Data was collected by interviewing the children’s caregiver using questionnaire about adherence that include self-report adherence, visual analogue scale, pill identification, and pill counts to determine overall adherence.
Results : There were 101 children included in this study with median age of 10 (7-16) years. There were 66.3% patients using the first line ARV drugs and 33.7% are on the second line. About 84% children are currently on ARV tablets, and 16% are using crushed tablet or mixed formulation (crushed tablets and tablets). There was no significant difference in children’s adherence among patients who had tablets and crushed tablets/mixed formulation (p = 0.851). However, there were 17% patients who refused to take ARV drugs when they have to change drug formulation.
Conclusions : In this study, there was no significant association between adherence and different drug formulation. However, there was a problem in adherence when a child changed their drug formulation. This study should be followed with study of the impact of difference drug formulation and the viral suppression among these children.
Keywords: Adherence Antiretroviral HIV children Drugs formulation
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