·
Pill characteristics size, taste, aftertaste concerns
·
Side effects list and prioritize the ones of concern
·
Symptom relieving medications - availability
·
Toxicity concerns short & long term
·
Timing and frequency of doses (once daily or twice daily) associated with better adherence
·
Food restrictions find out about dietary preferences in conjunction with pills
(whether patient prefers pills with food or fasting issues required)
·
Baseline viral load and CD4 cell count (the higher the baseline viral load, the more potent the regimen
needed to reach goal levels of undetectability
·
Treatment history heavily experienced patients may have more limited options;
additionally prior medications may have caused minor or major morbidity
these ought to be avoided
·
Health status of the patient more advanced patients have lower thresholds for toleration of
side effects
·
Known or suspected viral resistance
profiles (class specific) genotype / phenotype may be
needed (see DHHS guidelines)
·
Existing comorbidities conditions may limit HAART options because of drug interactions
and side effect profiles of concurrent medications
·
Domestic issues (living situation / storage restrictions) concern regarding
stability and storage issues for medications
·
Employment disclosure issues may need a regimen that can be taken outside of the work context
or safely & discreetly within the work context
- Polypharmacy concerns HAART meds
have multiple drug interactions that may limit options; adherence to
polypharmacy pill burden and pill fatigue are real issuesPill burden
desired vs tolerable