Switching from twice‐daily abacavir and lamivudine to the once‐daily fixed‐dose combination tablet of abacavir and lamivudine improves patient adherence and satisfaction with therapy

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Abstract
Background: Patients prefer fewer pills and once‐daily (qd) dosing without food restrictions. We assessed the impact on adherence [by Medication Event Monitoring System (MEMS) cap monitoring] of switching from abacavir (ABC) and lamivudine (3TC) twice daily (bid) to ABC/3TC fixed‐dose formulation (FDC, Kivexa®) qd to achieve a qd regimen.Methods: A randomized, open‐label, 8‐week study comparing adherence, efficacy and safety of immediate vs. delayed switching from ABC/3TC to FDC qd.Results: Ninety‐four patients were dosed. Significantly improved adherence was observed at week 4 with qd ABC/3TC across all three adherence variables: taking compliance 99.2% (90.7–100%) vs. 96.6% (60.0–100%) (P=0.017); dosing compliance 97.1% (64.3–100%) vs. 91.9% (33.3–100%) (P=0.016); and timing compliance 95.5% (53.8–100%) vs. 86.3% (4.3–100%) (P=0.006). Treatment satisfaction increased significantly at week 4 with ABC/3TC qd [92% (82–99%) vs. 85% (75–93%) (P=0.004)]. Two patients were withdrawn from the study because of intolerance to ABC/3TC.Conclusions: Switching from ABC and 3TC bid to ABC/3TC FDC qd significantly improved adherence by MEMS cap monitoring at week 4 and improved patient satisfaction with therapy. The results remain to be confirmed over a longer follow‐up. Use of qd regimens supports adherence and improves treatment satisfaction relative to bid regimens.

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