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.
引用
收藏
页码:644 / 657
页数:14
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