Your Old PillBox Still Has Some Life Left in It

HIVers who use pillbox organizers to help keep track of their medications can reduce their risk of progressing to AIDS, a new study shows. 'Pillbox organizers should be a standard intervention to improve adherence to antiretroviral therapy,' David Bangsberg of San Francisco General Hospital and colleagues conclude in their report, which was published in the October 1 issue of Clinical Infectious Diseases. HIVers who don't fully adhere to prescribed regimens run a greater risk of developing drug resistance, progressing to AIDS, and dying, according to the researchers. Pillbox organizers, they add, are the cheapest and most commonly used strategy to help people adhere to drug therapy. The researchers followed 245 HIV-infected men and women from 1996 through 2000, periodically checking their adherence to their antiretroviral regimens by conducting unannounced pill counts every three to six weeks. All study participants were taking at least three different medications. Because it would have been unethical to randomly assign some patients to use a pill organizer but not others, the researchers used statistical techniques to compare adherence for individuals who chose to use pillbox organizers and those who did not. Sixty-one percent of the study participants used the organizers for at least one month during the course of the study. Based on three different statistical models, the researchers found that pillbox users increased their adherence to prescribed drug regimens by up to 4.5%. They also had significantly lower levels of HIV in their blood and were nearly twice as likely to have a viral load of 400 or less. Pillbox users were also 11% less likely than nonusers to progress to an AIDS diagnosis during the course of the study.