Counselling: estrategia para mejorar la adherencia a los tratamientos antirretrovirales de alta eficacia.

Abstract

Background: The highly active antiretroviral treatment (HAART) is associated to a better quality of life of the HIV/AIDS people, however, it requires of an almost perfect fulfilment of the prescribed treatment. Objectives: Sistematic reviews of articles which try to improve the adherence to the HAARTs through educative programmes and watch the scientific evidence and quality of their publication. Search Strategy: The studies were identified in AIDSLINE, MEDLINE, CINAHL, EMBASE, The Library Cochrane, congresses abstracts, and national and international conferences about AIDS, since January/1996 until June/2004. Selection Criteria: Randomized Controlled Clinic Trials which show an educative intervention to improve the adherence to any type of prescription of HAARTs in HIV+ patients, which used one or more methods for the evaluation of the adherence, in which >80% of the individuals finished the complete programme and had a minimum following of 6 months. The quality of the studies was made following the recommendations of the CONSORT group, and the scientific evidence based on the Delphi Scale. Main Results: The investigations of all the sources gave a total of 1,013 dates. Of these articles, six of them observed the inclusion criteria and the rest were excluded. The most important results show that the counselling is the most used educative intervention in order to improve the adherence to the antiretroviral treatment. The study made by Jones based on the Delphi scale, is the one which has more scientific evidence as it observes 5 criteria out of 9. The studies with the highest publication quality are the ones made by Tuldra, Jones and Rawlings, which observe 14 criteria out of 22. Reviewers' conclusions: We need more clinic trials of educative programmes which improve the adherence to the antiretroviral treatments with a higher quality and more scientific evidence.