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A retrospective database study of initial patterns and adherence in patients with acquired immunodeficiency syndrome.

Specialists treating acquired immunodeficiency syndrome (AIDS) advocate aggressive treatment of the disease, but limited research suggests that this position is not widely held. A retrospective database study was conducted to identify initial treatment regimens prescribed for patients, changes in treatment regimens over time, and patient adherence to their treatment regimens. Two patient cohorts were identified: one initiating therapy after triple-drug therapy was introduced and before it was advocated as the treatment of choice; the other one initiating therapy after triple-drug therapy was advocated by the International AIDS Society. Four major findings indicate that (1) triple-drug therapy is prescribed as an initial therapy in 32% to 58% of patients; (2) after initiating therapy, many patients must switch or augment their treatment regimens; (3) by the end of the study period, 45% to 57% of patients were using a triple-drug regimen; and (4) the percentage of patients who were adherent less than 90% of the time varied from 37% to 83%, depending on the type of drug and complexity of treatment regimen. The results of this study provide further evidence of the utility of retrospective database studies to provide health care providers with cost-effective health care delivery information.