Effects of nurse-delivered home visits combined with telephone calls on medication adherence and quality of life in HIV-infected heroin users in Hunan of China

摘要

Aims and objectives. This study aimed to examine the effects of nurse-delivered home visits combined with telephone intervention on medication adherence, and quality of life in HIV-infected heroin users. Background. Drug use is consistently reported as a risk factor for medication non-adherence in HIV-infected people. Design. An experimental, pretests and post-tests, design was used: baseline and at eight months. Methods. A sample of 116 participants was recruited from three antiretroviral treatment sites, and 98 participants completed the study. They were randomly assigned to two groups: 58 in the experimental group and 58 in the control group. The experimental group received nurse-delivered home visits combined with telephone intervention over eight months, while the control group only received routine care. The questionnaire of Community Programs for Clinical Research on AIDS (CPCRA) Antiretroviral Medication Self-Report was used to assess levels of adherence, while quality of life and depression were evaluated using Chinese versions of World Health Organization Quality of Life Instrument - Abbreviated version (WHOQOL-BREF) and Self-rating Depression Scale, respectively. Data were obtained at baseline and eight months. Results. At the end of eight months, participants in the experimental group were more likely to report taking 100% of pills (Fisher's exact = 14·3, p = 0·0001) and taking pills on time (Fisher's exact = 18·64, p = 0·0001) than those in the control group. There were significant effects of intervention in physical (F = 10·47, p = 0·002), psychological (F = 9·41, p = 0·003), social (F = 4·09, p = 0·046) and environmental (F = 4·80, p = 0·031) domains of WHOQOL and depression (F = 5·58, p = 0·02). Conclusions. Home visits and telephone calls are effective in promoting adherence to antiretroviral treatment and in improving the participants' quality of life and depressive symptoms in HIV-infected heroin users. Relevance to clinical practice. It is important for nurses to recognise the issues of non-adherence to antiretroviral treatment in heroin users. Besides standard care, nurses should consider conducting home visits and telephone calls to ensure better health outcome of antiretroviral treatment in this population.