Examinando por Autor "Rubio, Rafael"

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Factors affecting patient adherence to highly active antiretroviral therapy
(SAGE, 2003-06) Escobar, Ismael; Campo, Mercedes; Martín , Jesús; Fernández-Shaw, Clara; Pulido, Federico; Rubio, Rafael
Objective: To determine the clinical and demographic variables related to adherence to highly active antiretroviral therapy (HAART) in patients treated in our hospital and identify the characteristics of nonadherent patients. Methods: Outpatients receiving treatment with HAART (n = 283) were asked about variables related to adherence and to complete the APGAR (family support), State-Trait Anxiety questionnaire (STAI) (emotional situation), and IAS (social support) questionnaires. Patients were classified in 2 groups depending on whether adherence was > or =95% or <95%. Adherence was defined as the percentage of dosage forms prescribed that were obtained by the patient at the hospital pharmacy. A multivariate analysis was created to analyze how each significant variable affected adherence. Results: Our data showed significant nonadherence for patients with the following factors: low level of education, unemployed, emotional situation, and abuse of substances including intravenous drugs. All significant variables were included in a logistic regression model to optimize the results. This model considered 4 variables: age (95% CI 0.89 to 0.99), number of antiretroviral drugs (95% CI 1.05 to 2.11), STAI Anxiety/Trait test (95% CI 2.02 to 6.02), and abuse of drugs (95% CI 1.20 to 3.95). Conclusions: We recommended special intervention to reinforce adherence for younger patients, patients taking a high number of antiretroviral drugs, those who have a history of intravenous drug use, and those with high anxiety status.
Outcomes of a health education intervention in a sample of patients infected by HIV, most of them injection drug users: Possibilities and limitations.
(Taylor&Francis, 2001-08) Martín, Jesús; Sabugal, Gustavo Manuel; Rubio, Rafael; Saiz-Maza, Mauricio; Blanco, José Manuel; Alonso, José Luis; Domínguez, Julia
We studied the receptivity of a population of HIV-infected patients to the development of a group educational intervention in order to enhance the adherence to therapy. We designed a group educational activity conducted by family physicians and directed to patients with HIV infection treated with antiretrovirals for at least six months. We conducted a randomized trial that compared two interventions: an educational intervention plus individual counsel or the last option alone. We studied their clinical situation, adherence to therapy and familial support. We offered 115 patients (66.9% injection drug users (IDUs), 69.6% males) the opportunity to be included in our trial, but 73.9% of them refused. No group with four or more participants was formed. Fifty-nine per cent refused to be included claiming personal reasons and 32.9% cited trouble in their jobs. There was a non-significant trend to accept in the case of women ( p = 0.19), patients with AIDS ( p = 0.11) and non-adherent patients ( p = 0.08). This trend was significant in the group of women with AIDS ( p = 0.01) and non-adherent women ( p = 0.05). We concluded that HIV-infected patients, mainly IDUs, are not receptive to group educational programmes. The design of future interventions must take into account the patients' characteristics.