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November 25, 1998

Improving Patient Compliance With HIV Treatment Regimens—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(20):1745. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-20-jac80013

In Reply.—We believe and in fact state in our article that improving adherence to antiretroviral therapy is the responsibility not only of patients, but also of clinicians, the pharmaceutical industry, and the health care system. Indeed, it is both naive and arrogant to place the responsibility for adherence to difficult and complex regimens solely on the patient. To do so risks both therapeutic failure and the public health consequences of drug resistance about which we write. Unfortunately, as Mr Ungvarski states, the training of clinicians in the principles and practice of ensuring adequate adherence to medications is inadequate. We agree and hope that increased awareness of the dangerous consequences of inadequate adherence to antiretroviral therapy will be a first step toward educating clinicians in how to assess and improve medication adherence among their patients.