TUESDAY, Dec. 1 (HealthDay News) -- HIV-infected patients on antiretroviral therapy who administer the drugs themselves achieve similar rates of adherence to the drug regimen as those who are directly observed taking their medication, according to a study published online Dec. 1 in The Lancet.

Nathan Ford, of Médecins Sans Frontières in Cape Town, South Africa, and colleagues conducted a meta-analysis of 12 studies comparing directly observed and self-administered antiretroviral therapy.

Of the 12 studies, four looked at homeless and drug user populations, both groups considered to be at high risk of poor adherence to therapy, while 10 studies comprising 1,862 participants reported data on virological suppression at study completion. The latter studies generated a pooled relative risk of 1.04 for directly observed versus self-administered treatment, the investigators discovered.

"The absence of a measurable benefit together with the burden of directly observed therapy on patients and health services calls into question the effectiveness of this intervention," the authors write. "The feasibility and cost of daily observation of lifelong treatment should also be taken into account, especially in resource-limited settings where patients might have to travel long distances to access under-resourced health services. Moreover, concerns about the intervention being a violation of patient autonomy and human rights give further cause for caution in use of this approach in the absence of clear benefit."

Abstract
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