Pos-_Infographic (2) Your Treatment Regimen Your treatment regimen can only be effective if you keep up your end of the partnership by taking your medications correctly and on time. This is called treatment adherence. It means you’re taking the correct dose of medications on time, every time, exactly as prescribed by your health care professionals. This isn’t always easy. But you want to achieve an undetectable viral load and high CD4 / T-cell count and by staying on your medication schedule is the way to do that. This section will help you understand why adhering to your treatment regimen is so important. It covers some of the challenges you may face and offers some tips to help you face those challenges successfully.   The Importance of Adhering to Your Regimen

  • HIV is constantly active from the moment it enters your body, seeking CD4 / T-cells cells to infect so it can reproduce.
  • Levels of HIV medications must be maintained at sufficient levels every hour of every day to stop HIV replication and suppress viral load.
  • When medication levels are too low, the virus can replicate. If this happens, the virus can mutate and develop a resistance to one or more of your medications. Your medications will stop working properly and your future treatment options may become limited. If a medication-resistant HIV strain is transmitted to others, it will be harder for them to treat their infection. Studies show that a 95% or greater adherence rate is needed for its full benefit.
  • Keep in mind that a person’s first regimen offers the best chance for long-term treatment success.

How to Ensure Proper Medication Adherence Understand exactly how your medications must be taken. Here is a checklist of questions to ask your doctor or pharmacist whenever a new medication is prescribed.

  • How many of each medication do I take at a time?

Most people need to take far fewer pills to treat HIV today than in the past. Three common treatment regimens contain three or four medications taken in one pill once per day. If you have difficulty swallowing pills, the count per dose is something you’ll want to discuss with your doctor.

  • How many times a day do to take each medication and when?

It will depend on the medication, but none of the most commonly prescribed HIV medications are taken more than twice a day. Some medications will be taken once or twice a day depending on whether or not you’ve used other HIV medications in the past.

  • Can I take HIV medications with other medications? Can I take them with supplements, over-the-counter-medication and herbal remedies?

HIV medications can interact with over-the-counter medications, medications prescribed for other diseases and conditions, and herbs and supplements. It’s important you let your doctor and pharmacist know which prescription and over-the-counter medications, supplements and herbal remedies you are taking. If you have any questions or concerns, call your doctor or pharmacist because some supplements can stop your medication from working correctly.

  • Do I take my medications with food or on an empty stomach?

Most HIV medications can be taken with or without food; however, some do have food requirements to ensure proper absorption and avoid side effects. Always read your prescription labels carefully.

  • What if I forget or miss a dose?

The best advice is to take a missed dose if it’s closer to the time of the missed dose than it is to the time of the next dose. For instance, if it’s been fewer than 12 hours since you missed your once-daily pill, take it as soon as you realize you’ve missed it; if it has been more than 12 hours, simply wait for the next scheduled dose. More important: if you frequently miss or forget doses, ask yourself why this is happening and figure out what you can do about it.

Make sure that you notify your healthcare provider if you miss doses.

  Finding the Best Treatment Regimen Your ability or willingness to take the medicine prescribed is important when choosing a new medication regimen or deciding if the regimen you’re on is right for you. Discuss your preferences, habits and any adherence obstacles with your health care professional. Adherence problems should not make you feel ashamed. An open, honest discussion will help you avoid adherence challenges and help your health care providers put together the best treatment regimen for you. Here is a check list of issues to discuss when making treatment decisions with your doctor.

  • Are you a creature of habit?

Do you do many things at the same time daily or does your schedule vary from day to day? The answer will help determine when and how often you take your medications.

  • Do you eat on a regular schedule?

Your answer can help determine the kind of food restrictions you can live with.

  • Do you have a problem swallowing pills?

Your doctor may be able to prescribe fewer or smaller pills and tablets.

  • Are you taking other prescriptions, over-the-counter medications or supplements?

Some medications cannot be taken together. Others may need different doses when they’re combined with other medications. Let your doctor and pharmacist know all the medications, over-the-counter medicines and supplements you’re taking.

  • Can you deal with potential side effects?

If you can’t deal with side effects, talk to your doctor about modifying the prescription. Always keep in mind that non-adherence result in inadequate levels of medications in the blood, leading to unnecessary side effects, and virus replication.

Three Adherence Challenges

  • Your Mood – People who are depressed find it more difficult to adhere to an HIV medication regimen. The symptoms of depression can differ from person to person and include much more than just feeling down or sad. Body aches, irritability, crying, difficulty sleeping and mood swings can all be signs of depression. There are many effective ways to treat depression. If you think you are depressed, discuss it with your health care provider.
  • Stress– Unpredictable, overwhelming schedules, too many demands on your time, financial problems, concerns about your living conditions, family problems and work overload can all cause stress that affect your ability to adhere to a treatment regimen. Ask your health care provider for a referral to resources in your area to help you cope with stress in your life.
  • Caring for Others – Being a caregiver can be overwhelming and cause you to lose focus on caring for yourself. Remember that you cannot care for others if you aren’t well. Make your health a priority to make sure you are the best you can be to take care of others.

What Regimen is Right for You? HIV treatment has come a long way since the mid-1990s, when people often required up to 20 pills to be taken several times a day. Today some regimens require just one pill daily. The right program for you will depend on a number of factors.

  • Once a day means once ever 24 hours, not once a day whenever you get around to taking the pill. Delays between once-a-day doses can cause medication levels to fluctuate in your body and lead to the development of medication resistance.
  • The rate at which your body metabolizes HIV medications determine how forgiving a treatment regimen will be if you sometimes forget to take your medications. A medication is considered forgiving if it achieves blood levels that stay above the minimum needed to keep your HIV under control for several hours after your next dose is scheduled. A medication is less forgiving and requires strict adherence if it rapidly falls below the necessary blood level shortly following the time of your next scheduled dose. It is important to know about your specific medications.
  • There is no conclusive evidence that people who take medications once a day adhere to their regimen any better than those who take medications twice daily. There is some concern among experts that missing once-a-day medications may leave you at greater risk of developing medication resistance than missing more frequently prescribed doses.

Tips for Successful Adherence to Medications

  • Is there something you do automatically every day at the same time, like brush your teeth, make coffee, or turn on the TV? Put your medications next to those objects.
  • Some clinics, service organizations and pharmacies offer free reminder programs that will call or text to remind you to take your medication. Ask your healthcare professional if this service is available in your area.
  • Your cell phone may include a program that will alert you at pre-set times.
  • Do you travel often? Be sure to carry your medication in your carry-on luggage and bring a couple days’ worth of extra doses in case of delays, cancellations or lost luggage.
  • To prevent serious medication interactions, it’s a good idea to bring all of your medications including prescriptions, over-the-counter, supplements and herbal remedies to your healthcare provider periodically for a complete review.
  • There are affordable one-week, two-week and one-month pill boxes that let you organize your medication ahead of time.
  • Some pharmacies will sort all of your daily medications and organize them into individual dosage packets instead of separate pill bottles. Ask if your pharmacy provides this service.
  • Look into portable pocket-sized pill cases with built-in alarm clocks. These are useful if you travel frequently or need to take your medication on the go.