A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

Autor: R. M. Nance, Heidi M. Crane, Joseph A.C. Delaney, Paul K. Crane, Mari M. Kitahata, Mary E. McCaul, Ira B. Wilson, R. J. Fredericksen, R. D. Harrington, S. A. Safren, W. B. Lober, Jane M. Simoni, Michael J. Mugavero, A. Church, Shireesha Dhanireddy
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
Social Psychology
Anti-HIV Agents
Substance-Related Disorders
Missed Dose
HIV Infections
Comorbidity
Patient Health Questionnaire
Article
Medication Adherence
03 medical and health sciences
0302 clinical medicine
Antiretroviral Therapy
Highly Active
Surveys and Questionnaires
Internal medicine
Humans
Medicine
030212 general & internal medicine
Clinical care
Depression (differential diagnoses)
Depressive Disorder
030505 public health
business.industry
Public Health
Environmental and Occupational Health
Bayes Theorem
Alcohol users
Middle Aged
Viral Load
Antiretroviral therapy
Logistic Models
Infectious Diseases
Increased risk
Immunology
Linear Models
Female
Substance use
0305 other medical science
business
Alcohol-Related Disorders
Viral load
Zdroj: AIDS and Behavior. 21:470-480
ISSN: 1573-3254
1090-7165
DOI: 10.1007/s10461-016-1566-8
Popis: Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.
Databáze: OpenAIRE
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