What is adherence?

Answer 1

The word 'adherence' is used to describe taking your drugs exactly as prescribed - at the right times, in the right doses and following any special dietary restrictions. It is a term that is particularly used in the treatment of HIV, where the importance of developing, and sticking to, what can be a very complicated daily schedule of drugs can not be overemphasised. Generally speaking, HIV drugs need to be taken within a window period of an hour. If this does not happen, then the drugs fall below therapeutic levels and HIV is given a chance to replicate at a rate at which it can mutate and develop resistance to your drugs. With HIV drugs, the unpalatable fact is that you need to get as close as you possible can to achieving 100% adherence. The very occasional missed / late dose probably isn't going to do a lot of damage; but if you are even missing more than just a few doses per year, then the evidence is quite clear that it becomes significantly more difficult to achieve / maintain target viral suppression. At 95% adherence (eighteen missed / late doses per year if you are on a once daily regimen) only 81% of patients achieve target viral suppression … and at 85% adherence (one dose missed per week on a once daily regimen) only 50% of patients achieve target viral suppression. Fall much below that and you have virtually no chance of ever achieving target viral suppression. Many HIV treatment centres now have an adherence clinic, or an adherence nurse, dedicated to helping their patients adjust their life around their medication needs.