Comparison of pharmacy-based measures of adherence to antiretroviral therapy as predictors of virological failure.
AIDS Behav
; 19(4): 612-8, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25433652
ABSTRACT
We compared multiple pharmacy refill-based adherence indicators for antiretroviral therapy, as well as thresholds for defining non-adherent behavior, based on ability to predict virological failure. A total of 29,937 pharmacy visits with corresponding viral load assessments were contributed by 8,695 patients attending a large clinic in Johannesburg, South Africa. Indicators based on pill coverage and timing of refill pickup performed comparably using the strictest thresholds for adherence [100 % pill coverage odds ratio (OR) (95 % confidence interval (CI)) 1.26 (1.15, 1.39); prescription picked up on or before scheduled refill date 1.27 (1.16,1.38)]. For both types of indicators, the association between non-adherence and virological failure increased as the threshold defining adherent behavior was lowered. All measures demonstrated high specificity (range 84-98 %), but low sensitivity (5-19 %). In this setting, patients identified as non-adherent using pharmacy-based indicators are likely correctly classified and in need of interventions to improve compliance. Pharmacy based measures alone, however, are inadequate for identifying most cases of nonadherence.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Farmácias
/
Prescrições de Medicamentos
/
Infecções por HIV
/
Carga Viral
/
Terapia Antirretroviral de Alta Atividade
/
Adesão à Medicação
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
AIDS Behav
Assunto da revista:
CIENCIAS DO COMPORTAMENTO
/
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2015
Tipo de documento:
Article