Table 1.
Characteristics of observational studies identified by the systematic literature review that assess the relationship between adherence and use of STR vs MTR (objective 1)
| Study, year(country or region) | Study population (study period) | Sample size | Adherence measurement | Results | Did STR improve Adherence (yes/no)? |
|---|---|---|---|---|---|
| Cohen et al,33 2013 (USA) | Medicaid patients with an HIV diagnosis from 2005 to 2009 receiving complete ART (ie, two nucleoside/nucleotide reverse transcriptase inhibitors plus a third agent) for ≥60 days as STR or 2+PPD (2005–2009) | STR: 1,797 MTR: 5,584 | MPR | Patients who received ART as a single pill per day were significantly more likely to be highly adherent to therapy than those who received MTR | Yes |
| Cooke et al,34 2014 (USA) | Managed care members with HIV and ART regimen recommended by US Department of Health and Human Services 2011 Antiretroviral Guidelines (2010–2011) | STR: 1,136 MTR: 1,241 | MPR | Patients who received STRs were about 1.3-times more likely to be adherent to therapy (ie, MPR ≥90%) than those receiving more than one ART | Yes |
| Hanna et al,5 2014 (USA) | Any person-visit in the Women’s Interagency HIV Study during which an HIV-infected woman self-reported ART use in the previous 6 months and had a valid HIV-1 viral load measurement (2006–2013) | STR: 1,846a MTR: 5,584b | Self-reported | STR use was associated with increased adherence and virologic suppression | Yes |
| Kauf et al,35 2012 (USA) | Patients with ≥1 pharmacy claim for ABC-3TC or for ≥2 components of an NRTI backbone (1997–2005) | STR: 650 MTR: 1,947 | MPR | Use of an STR improved adherence to a third regimen component and, thus, the likelihood of achieving the accepted standard for adherence to HIV therapy of 95% | Yes |
| Langness et al,36 2014 (USA) | Patients (aged ≥18 years) on any prescribed HIV ART, scheduled prescription blood pressure medication, or scheduled prescription mental health medication (2012–2013) | STR: 282 MTR: 295 | PDC | People with HIV were more adherent to a once-daily STR than to a once-daily MTR | Yes |
| Rogato et al,37 2016 (Europe) | HIV-infected patients on an ART regimen recommended by European AIDS Clinical Society guidelines, version 7.0 (2009–2013) | STR: 404c MTR: 404c | PDC | STRs were associated with improved adherence when compared with a matched cohort of patient regimens consisting of recommended once-daily MTRs | Yes |
| Raffi et al,38 2015 (France) | Treatment-naïve HIV-positive patients (aged ≥18 years) (2006–2011) | STR: 76 MTR: 242 | MPR | Significant benefit in terms of adherence was observed with the STR in comparison with regimens with one daily intake but no difference was observed when compared with regimens involving >1 pill once daily | Yes |
| Sax et al,39 2012 (USA) | Commercially insured patients in the LifeLink database with an HIV diagnosis between June 1, 2006 and December 31, 2008, and receipt of a complete ART regimen (2006–2008) | STR: 2,365 MTR: 4,708 | MPR | ART consisting of a single pill per day was associated with significantly better adherence and lower risk of hospitalization in patients with HIV than in those receiving ≥3 pills per day | Yes |
| Sutton et al,40 2016 (USA) | Patients with HIV covered by South Carolina Medicaid (2006–2013) | STR: 580 MTR: 1,594 | PDC | The STR was associated with higher adherence rates and a lower risk of hospitalization (both in the adjusted and unadjusted analyses) | Yes |
| Taneja et al,41 2012 (USA) | Patients (aged ≥18 years) with HIV, who began EFV/FTC/TDF or other EFV+≥2 NRTIs regimens or NVP+≥2 NRTI regimens between January 1, 2003 and September 30, 2009 (2003–2009) | STR: 1,874 MTR: 1,100 | PDC | Adherence was lower for both EFV+≥2 NRTIs (MTR) and NVP+≥2 NRTIs (MTR) than for EFV/FTC/TDF (STR) | Yes |
| Tennant et al,32 2015 (USA) | Treatment-naïve HIV-positive patients (aged 18 years) (2007–2010) | STR: 165 MTR: 224 | MPR | Treatment regimen was not predictive of adherence. A once- daily protease inhibitor-based MTR may result in comparable adherence to an STR in a rural HIV-infected population | No |
Notes:
a
Person visits.
b
Person visits (after propensity score matching).
c
After propensity score matching.
Abbreviations: ABC-3TC, abacavir and lamivudine; AIDS, acquired immune deficiency syndrome; ART, antiretroviral therapy; EFV, efavirenz; FTC, emtricitabine; HIV, human immunodeficiency virus; MPR, medication possession ratio; MTR, multiple-tablet regimen; NRTI, nucleoside reverse transcriptase inhibitor; NVP, nevirapine-based regimen; PDC, proportion of days covered; PPD, pills per day; STR, single-tablet regimen; TDF, tenofovir disoproxil fumarate.