Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11651
It made me more confident that I have it under control: Patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain
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ISSN: 1932-6203
WOS ID: 000536957700032
Scopus EID: 2-s2.0-85084917175
PMID: 32357195
Embase PUI: L2005784750
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2020-05-01Document type
research articleCitation
Davis W, Mantsios A, Karver T, Murray M, Punekar Y, Ward D, et al. It made me more confident that I have it under control: Patient and provider perspectives on moving to a two-drug ART regimen in the United States and Spain. PLoS One. 2020 May 01;15(5):e0232473.Abstract
Background Two-drug regimens (2DR) to treat HIV infection have the potential to reduce long-term toxicity and increase therapeutic options for people living with HIV (PLHIV). Prior phase III trials, SWORD-1 and SWORD-2, as well as GEMINI-1 and GEMINI-2, have demonstrated that a dolutegravir-based 2DR is as effective as three-or four-drug regimens among virologically suppressed patients. Limited information exists, however, on patient and provider experiences with 2DR to inform roll-out and integration into routine clinical care. Methods We conducted 39 in-depth interviews with PLHIV currently on 2DR in the context of routine care and 8 of their clinical care providers in the United States (U.S.) and Spain. Participants included 33 male and 6 female PLHIV and 8 providers. Interview topics explored perceptions of and experiences with 2DR compared to prior anti-retroviral regimens (ARVs), side effects, patient satisfaction, and clinical performance. Interviews were audio-recorded, transcribed and analyzed using thematic content analysis. Results Participants viewed 2DR as a significant and positive advance, in terms of its ability to effectively treat HIV with reduced toxicity and essentially no reported side effects. Patients noted the central role providers played in the decision to switch to a 2DR regimen and, among U. S. participants, the importance of insurance coverage making this preferred option feasible. Patients aynd providers agreed that a 2DR regimen would be appropriate for any PLHIV regardless of whether they were treatment naive or had significant experience with ARVs. Conclusions Participants' experiences with a 2DR regimen were positive with no participants, reporting side effects and all reporting continued viral suppression. Providers valued the reduced toxicity offered by 2DR and served as the primary gateway to a transition to 2DR for patients in both settings. This study provides a foundation for further research on the transition to 2DR regimens in other populations and contexts including low- and middle-income settings.
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https://dx.doi.org/10.1371/journal.pone.0232473MeSH
AgedDecision Making
Spain
United States
Adult
Humans
Anti-HIV Agents
Drug Therapy, Combination
Middle Aged
Cross-Sectional Studies
HIV Infections
Male
Patient Preference
Drug Costs
Attitude of Health Personnel
Female
Patient Acceptance of Health Care
DeCS
Prioridad del PacienteCostos de los Medicamentos
Femenino
Infecciones por VIH
Actitud del Personal de Salud
Masculino
Estudios Transversales
Quimioterapia Combinada
Fármacos Anti-VIH
Humanos
Persona de Mediana Edad
Anciano
Toma de Decisiones
Aceptación de la Atención de Salud
Adulto
Estados Unidos
España