Patient Retention and Adherence to Antiretrovirals in a Large Antiretroviral Therapy Program in Nigeria: A Longitudinal Analysis for Risk Factors

Autor: Emeka Eze, William A. Blattner, I. A. Ibanga, Abdulrazaq G. Habib, Modupe Oyegunle, Samuel Ajayi, Renata H. Benjamin, Man Charurat, Prosanta Mondal, Prince U. Ele, John Farley, Emilia Iwu, Patrick Dakum, Alash'le Abimiku, Usman Gebi, Mary-Ann Etiebet, Maria Eng
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
MEDLINE
lcsh:Medicine
Nigeria
Pharmacy
HIV Infections
Pharmacology
Medication Adherence
03 medical and health sciences
Zidovudine
0302 clinical medicine
Pharmacotherapy
Evidence-Based Healthcare/Health Services Research and Economics
Risk Factors
Antiretroviral Therapy
Highly Active
Epidemiology
medicine
Humans
030212 general & internal medicine
Longitudinal Studies
lcsh:Science
Intensive care medicine
Proportional Hazards Models
Pharmacies
030505 public health
Multidisciplinary
business.industry
Proportional hazards model
lcsh:R
Public Health and Epidemiology/Global Health
Infectious Diseases/HIV Infection and AIDS
Antiretroviral therapy
3. Good health
Anti-Retroviral Agents
Cohort
Patient Compliance
Regression Analysis
lcsh:Q
Female
0305 other medical science
business
medicine.drug
Research Article
Follow-Up Studies
Zdroj: PLoS ONE
PLoS ONE, Vol 5, Iss 5, p e10584 (2010)
ISSN: 1932-6203
Popis: Background Substantial resources and patient commitment are required to successfully scale-up antiretroviral therapy (ART) and provide appropriate HIV management in resource-limited settings. We used pharmacy refill records to evaluate risk factors for loss to follow-up (LTFU) and non-adherence to ART in a large treatment cohort in Nigeria. Methods and Findings We reviewed clinic records of adult patients initiating ART between March 2005 and July 2006 at five health facilities. Patients were classified as LTFU if they did not return >60 days from their expected visit. Pharmacy refill rates were calculated and used to assess non-adherence. We identified risk factors associated with LTFU and non-adherence using Cox and Generalized Estimating Equation (GEE) regressions, respectively. Of 5,760 patients initiating ART, 26% were LTFU. Female gender (p350 and 2 hours to the clinic (p = 0.03), had total ART duration of >6 months (p200 at ART initiation were at a higher risk of non-adherence. Patients who disclosed their HIV status to spouse/family (p = 0.01) and were treated with tenofovir-containing regimens (p≤0.001) were more likely to be adherent. Conclusions These findings formed the basis for implementing multiple pre-treatment visit preparation that promote disclosure and active community outreaching to support retention and adherence. Expansion of treatment access points of care to communities to diminish travel time may have a positive impact on adherence.
Databáze: OpenAIRE
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