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Prevalence and correlates of nonadherence to antiretroviral therapy in a population of HIV patients using Medication Event Monitoring System®
被引:62
|作者:
Deschamps, AE
De Graeve, V
Van Wijngaerden, E
De Saar, V
Vandamme, AM
Van Vaerenbergh, K
Ceunen, H
Bobbaers, H
Peetermans, WE
De Vleeschouwer, PJ
De Geest, S
机构:
[1] Katholieke Univ Leuven, Fac Med, Sch Publ Hlth, Ctr Hlth Serv & Nursing Res, B-3000 Louvain, Belgium
[2] Univ Hosp KU Leuven, Dept Internal Med, Louvain, Belgium
[3] Katholieke Univ Leuven, Rega Inst, Louvain, Belgium
[4] Univ Ghent, Dept Sociol, B-9000 Ghent, Belgium
[5] Univ Basel, Inst Nursing Sci, Basel, Switzerland
关键词:
D O I:
10.1089/apc.2004.18.644
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Nonadherence to antiretroviral therapy ( ART) jeopardizes good clinical outcome in people living with HIV. In a single-center prospective study, prevalence and correlates of nonadherence were investigated in 43 patients on ART. Nonadherence was assessed using Medication Event Monitoring System (MEMS), self-report and collateral report of treating physicians. Based on MEMS data, median taking adherence, dosing adherence, and timing adherence was 98% (interquartile range [IQR] = 5.3), 91.5% (IQR = 18), and 86% (IQR = 31.5), respectively. The median number of drug holidays per 100 days was 0.8 (IQR = 4.8). The prevalence of nonadherence measured by MEMS was 40%. Self-reported nonadherence and collateral report of nonadherence by physicians varied from 5% to 41% and 24% to 28%, respectively. Patients were categorized as adherent or nonadherent based on a clinically validated algorithm derived from MEMS parameters. Nonadherent patients used significantly more escaping coping strategies (p = 0.003) and planned problem solving strategies (p = 0.049), were prescribed significantly more antiretroviral medications (p = 0.02) and were significantly longer on ART (p = 0.04) than adherent patients. Identified correlates of nonadherence may help clinicians in detecting patients with HIV at risk for nonadherence and can support the development of adherence enhancing interventions.
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页码:644 / 657
页数:14
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