Background: The benefits of antiretroviral therapy (ART) cannot be experienced if they are not taken as prescribed.\r\nYet, not all causes of non-adherence are dependent on the patient. Having to pay for medication reduces\r\nadherence rates. Non- adherence has severe public health implications which must be addressed locally and\r\nglobally. This paper seeks to describe the trends in adherence rates reported in Cameroon and to investigate the\r\ndeterminants of adherence to ART in the Cameroon Mobile Phone SMS (CAMPS) trial.\r\nMethods: We conducted a systematic review of electronic databases (PubMed, Google Scholar, Web of Science,\r\nCINAHL, EMBASE and PSYCINFO) for publications on adherence to ART in Cameroon (from January 1999 to May\r\n2012) and described the trend in reported adherence rates and the factors associated with adherence. Data were\r\nextracted in duplicate. We used multivariable analyses on the baseline data for 200 participants in the CAMPS trial\r\nto determine the factors associated with adherence in four models using different measures of adherence (more\r\nthan 90% or 95% on the visual analogue scale, no missed doses and a composite measure: 100% on the visual\r\nanalogue scale, no missed doses and all pills taken on time).\r\nResults: We identified nine studies meeting our inclusion criteria. Adherence to ART in Cameroon has risen steadily\r\nbetween 2000 and 2010, corresponding to reductions in the cost of medication. The factors associated with\r\nadherence to ART in Cameroon are grouped into patient, medication and disease related factors. We also identified\r\nfactors related to the health system and the patient-provider relationship. In the CAMPS trial, education, side effects\r\nexperienced and number of reminder methods were found to improve adherence, but only using multiple\r\nreminder methods was associated with better adherence in all the regression models (Adjusted Odds Ratio [AOR]\r\n4.11, 95% Confidence Interval [CI] 1.89, 8.93; p<0.001; model IV).\r\nConclusions: Reducing the cost of ART is an important aspect of ensuring adequate adherence rates. Using\r\nmultiple reminder methods may have a cumulative effect on adherence to ART, but should be investigated further.
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