Date Published: December 2, 2018
Author(s): Yitayih Kefale Gelaw, Boressa Adugna, Adino Tesfahun Tsegaye, Tadesse Melaku, Belayneh Kefale.
Adverse effects from antiretroviral therapy (ART) have an impact on quality of life and medication adherence. There is no clear understanding of how people manage the adverse effects of ART. The individual taking medications which cause serious adverse effects may choose to stop or reduce the medications to relieve the adverse effects. Hence, this study was aimed at assessing coping strategies for adverse effects of ART among adult human immunodeficiency virus (HIV) patients.
A cross-sectional study was conducted at HIV clinic of University of Gondar Referral Hospital (UoGRH). A total of 394 study participants were recruited by systematic random sampling. Data were collected through interviewing patients. Data were entered to Epi-Info 3.5.4 and analyzed using SPSS-20.0. Descriptive statistics were used to summarize patient’s sociodemographic data and the adverse effects of their ART regimen. Binary and multivariate logistic regressions were used to investigate the potential predictors of nonadherence coping strategies.
The majorities of study participants were females (66%) and aged between 35 and 44 years (38.1%). The major adverse effects reported by the participants were headache (48.2%) followed by fatigability (18%) and loss of appetite (17.5%). Coping strategies used by HIV patients for adverse effect of ART were positive emotion coping strategy (91.1%), social support seeking (76.6%), taking other medications (76.6%), information seeking (48.7%), and nonadherence (35.5%). Younger age (AOR = 29.54, 95% CI = 2.49–35.25, p = 0.007), low level of education (AOR = 5.70, 95% CI = 2.16-15.05, p < 0.001), and living far from the health institution (AOR = 2.68, 95% CI = 1.29–5.57, p = 0.008) were associated with nonadherence coping strategy to relieve the adverse effects of ART. The present study revealed that positive emotion coping was the most commonly used strategy. Age, level of education, and distance from health institution were the predictors of nonadherence coping strategy.
Adverse drug reactions (ADRs) are any noxious, unintended, and undesired effect of a drug, which occurs at doses used in humans for prophylaxis, diagnosis, or therapy, or for the modification of physiological functions [1, 2], while symptoms are subjective complaint that is reported by patients due to some disease state or medications. Adverse effects from ART are common and were the most common reason for switching or discontinuing therapy and for medication nonadherence [3, 4]. Adverse effects are not typically life-threatening but can impact the quality of life (QoL), negatively affect patients’ willingness to adhere to their regimens, and influence decisions about healthcare [5, 6]. A better understanding of how patients cope with undesirable adverse effects from treatment can inform interventions to remediate the negative impact of adverse effects on treatment adherence and QoL. Coping is defined as the cognitive and behavioral responses that an individual employs to deal with the stressors. Coping can take the form of active behavior (problem-focused), regulation of distress (emotion-focused), or the maintenance of well-being (meaning-based) . One of the major challenges for patient being nonadherent to their ART is the incidence of ADRs. The main coping strategies for adverse effect of ART include nonadherence, social support seeking, using positive emotion, information seeking, and taking other medications [4, 7–12].
The present study was aimed at assessing the major adverse effects of ART and coping strategies taken by HIV patients for these adverse effects. About 394 HIV patients who had adverse effects were studied for coping strategy(s) of the adverse effect they faced. They used five coping strategies (positive emotion, social support seeking, information seeking, taking other medications, and nonadherence).
The present study revealed that positive emotion coping was the most commonly used strategy. Age, level of education, and distance from health institution were the predictors of nonadherence coping strategy.