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

H. M. Crane, R. M. Nance, J. A.C. Delaney, R. J. Fredericksen, A. Church, J. M. Simoni, R. D. Harrington, S. Dhanireddy, S. A. Safren, M. E. McCaul, W. B. Lober, P. K. Crane, I. B. Wilson, M. J. Mugavero, M. M. Kitahata

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)470-480
Number of pages11
JournalAIDS and behavior
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • Adherence
  • Depression
  • Hazardous alcohol use
  • Substance use
  • Viral load

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Crane, H. M., Nance, R. M., Delaney, J. A. C., Fredericksen, R. J., Church, A., Simoni, J. M., Harrington, R. D., Dhanireddy, S., Safren, S. A., McCaul, M. E., Lober, W. B., Crane, P. K., Wilson, I. B., Mugavero, M. J., & Kitahata, M. M. (2017). A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better? AIDS and behavior, 21(2), 470-480. https://doi.org/10.1007/s10461-016-1566-8