Provider assessment of adherence to HIV antiretroviral therapy.
J Acquir Immune Defic Syndr
; 26(5): 435-42, 2001 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-11391162
ABSTRACT
BACKGROUND:
Adherence assessment is an essential component of monitoring HIV antiretroviral therapy. Prior studies suggest that medical providers frequently estimate individual patient adherence inaccurately.OBJECTIVE:
We compared provider estimates of nonadherence to antiretroviral therapy with unannounced pill counts and structured patient interviews to determine the accuracy of adherence information obtained by providers and patients. DESIGN, SETTING, ANDPARTICIPANTS:
Comparison of three adherence measures in homeless or marginally housed persons receiving HIV antiretroviral therapy (n = 45) and their providers (n = 35). MEASUREMENTS Provider estimate of percentage of pills taken; three successive patient structured reports of number of doses missed in the last 3 days; and three successive unannounced pill counts.RESULTS:
13% (95% confidence interval [CI], 4%-22%) of patients were not following their regimen as directed. Provider-adherence estimate explained only 26% (95% CI, 6%-47%) of the variation in pill count adherence, whereas patient report explained 72% (95% CI, 52%-96%). The sensitivity and specificity of provider estimates of nonadherence, defined as <80% of pills taken by pill count, were 40% and 85%, respectively. The sensitivity and specificity of patient interview were 72% and 95%, respectively.CONCLUSIONS:
Provider estimate of adherence was inaccurate whereas structured patient report was more closely related to pill count. Structured assessment over several short intervals may improve accuracy of adherence assessment in clinical practice.
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Banco de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Cooperación del Paciente
/
Evaluación de Resultado en la Atención de Salud
/
Personal de Salud
/
Terapia Antirretroviral Altamente Activa
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Acquir Immune Defic Syndr
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos