Inexpensive pill box organizers are an easy, successful, and cost-effective tool to help patients take their medications as prescribed, according to a new study of low-income urban residents living with HIV infection by authors from the Berkeley School of Public Health and the University of California, San Francisco (UCSF).
The research is published in the Oct. 1 issue of Clinical Infectious Diseases, now available online.
“Clinicians and pharmacists can meaningfully improve treatment outcomes with simple and inexpensive strategies, such as pill box organizers, to help people organize how they take medication,” said senior author David Bangsberg, MD, MPH, of UCSF.
Incomplete adherence to HIV therapy is the most common cause of incomplete viral suppression, drug resistance, disease progression, and death among people living with HIV/AIDS. The subjects of this study, who were recruited from homeless shelters, free food programs, and single-room occupancy hotels, are thought to be at elevated risk for poor adherence partly because of the high rates of substance abuse, untreated mental illness, and unstable housing.
Patients in this difficult-to-treat population were given inexpensive pill box organizers to use with their antiretroviral medications. Study organizers made a total of 3,170 unannounced visits every three to six weeks to the subjects' places of residence and compared the number of pills remaining in the patients' possession with the number that would be expected to remain if the patients were perfectly compliant with the treatment regimen.
Pill box organizers were associated with a 4 percent improvement in adherence, 0.12 log reduction in HIV viral load, and an estimated 11 percent reduction in the risk of progression to clinical AIDS. At only $5 per pill box, this intervention was highly cost-effective.