† In memory of Dr. Susan M. King.
Palatability, adherence and prescribing patterns of antiretroviral drugs for children with human immunodeficiency virus infection in Canada†
Article first published online: 21 SEP 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 20, Issue 12, pages 1246–1252, December 2011
How to Cite
Lin, D., Seabrook, J. A., Matsui, D. M., King, S. M., Rieder, M. J. and Finkelstein, Y. (2011), Palatability, adherence and prescribing patterns of antiretroviral drugs for children with human immunodeficiency virus infection in Canada. Pharmacoepidem. Drug Safe., 20: 1246–1252. doi: 10.1002/pds.2236
- Issue published online: 22 NOV 2011
- Article first published online: 21 SEP 2011
- Manuscript Accepted: 17 JUL 2011
- Manuscript Revised: 24 JUN 2011
- Manuscript Received: 16 OCT 2010
- antiretroviral therapy;
- prescribing patterns;
To assess the impact of perceived palatability of antiretroviral drugs on adherence to therapy of children infected by human immunodeficiency virus and on prescribing patterns by their caring physicians.
Design: Two arms—retrospective chart review and a cross-sectional survey.
Setting: Tertiary-care pediatric human immunodeficiency virus clinic during a 17-year period.
Participants: Children with human immunodeficiency virus infection and physicians actively caring for children with human immunodeficiency virus infection in seven provinces in Canada were surveyed regarding their perception of the palatability of 8-liquid and 15 non-liquid antiretroviral medications and its effect on drug selection.
Main Outcome Measure: Effect of taste preferences of antiretroviral drugs on adherence to treatment by infected children and on drug selection by their caring physicians.
Forty of 119 children (34%) refused at least once to an antiretroviral medication. In 5%, treatment was discontinued because of poor palatability. Ritonavir was the least palatable drug (50% of children; p = 0.01). Ritonavir use (OR 4.80 [95%CI 1.34–17.20]) and male gender (OR 7.25 [95%CI 2.30–22.90]) were independent predictors of drug discontinuation because of poor taste. Physicians also perceived liquid ritonavir as the least palatable (p = 0.01) and the most likely to be discontinued (p = 0.01). However, they commonly prescribed it as first-line therapy (p = 0.06).
A third of children infected with human immunodeficiency virus fail to adhere to their treatment because of poor drug taste. Physicians are aware of that, but this does not prevent them from selecting the least palatable drugs as first-line therapy. Copyright © 2011 John Wiley & Sons, Ltd.