Provider guidance for linking patients to antiretroviral therapy adherence interventions: recommendations from an IAPAC advisory committee on adherence monitoring and support

Abstract

High, persistent levels of antiretroviral therapy (ART) adherence are generally required to achieve sustained virologic suppression. Recently published global guidelines on entry into and retention in care and ART adherence include recommendations for monitoring and supporting ART adherence as a standard part of HIV clinical management. Several tools to facilitate the dissemination and implementation of these evidence-based guidelines are under development. A pocket-size Guidelines Regimen Information Program (GRIP) guide was recently developed as a quick reference tool to summarize high impact, strong evidence-based recommendations and to provide a validated single assessment item for use in collecting self-reported adherence estimations from patients as part of standard clinical care. The tool's development and intended use are reviewed and additional recommendations provided to facilitate a brief clinician-patient discussion to link patients to appropriate resources, strategies, or programs. Limitations of the tool and scenarios to avoid are also discussed. With a sizable proportion of individuals on ART trying to achieve or sustain sufficiently high rates of adherence, proactive monitoring of ART adherence and linkage of patients to needed resources is a critical component of high-quality HIV care. The quick reference GRIP guide is intended to be a part of a larger package of approaches to identify patients in need of adherence support regardless of current viral load and to help providers link patients with the available resources.