The Effect of Daily Pill Burden on the Probability of Discontinuation of Initial HAART Regimens

Abstract

Background: Given that lower pill burdens have been shown to be associated with an increased duration of initial therapy, there is a need to understand the effect of daily pill burden on the duration of the initial regimen. Objective: The objective of this study was to analyze the effect of daily pill burden of the initial HAART regimen prescribed to a cohort of mostly minority, underserved female patients on their time to discontinuation of this regimen. Methods: Survival analysis, including Kaplan-Meier curves, log-rank tests, and a Cox proportional hazards model were used to answer research questions, in addition to analyses such as paired samples t-test, Fisher’s exact test, and ANOVA procedures. Results: Overall, 1 pill/day regimens were associated with the lowest time to discontinuation of all four categories of pill burden groups. 1 pill/day regimens were shown to have a statistically significant longer time to discontinuation than any other initial regimen prescribed in this cohort. Discussion: Patients started on the only 1 pill/day regimen used at this cohort (Atripla) stayed on this regimen for a statistically significant longer duration than patients started on any other regimen in this cohort. Every pill added to the initial regimen was shown to increase the hazard of discontinuation 23.0% in this cohort. Conclusions: Overall, 1 pill/day regimens were associated with the longest time to discontinuation, and pill burden was shown to be a significant contributor to the hazard of discontinuation.