TY - JOUR
T1 - A randomized comparison of two instruments for measuring self-reported antiretroviral adherence
AU - Mannheimer, S.
AU - Thackeray, L.
AU - Hullsiek, K. Huppler
AU - Chesney, M.
AU - Gardner, E. M.
AU - Wu, A. W.
AU - Telzak, E. E.
AU - Lawrence, J.
AU - Baxter, J.
AU - Friedland, G.
N1 - Funding Information:
1Columbia University College of Physicians & Surgeons and Harlem Hospital Center, Division of Infectious Diseases, New York, 2Division of Biostatistics, University of Minnesota, Minneapolis, 3Division of Extramural Research & Training, National Center for Complementary & Alternative Medicine, National Institutes of Health, Bethesda, MD, 4Division of Infectious Diseases, Denver Public Health, The University of Colorado at Denver and Health Sciences Center, Denver, 5Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD, 6Department of Medicine and Department of Epidemiology & Population Health and Albert Einstein College of Medicine and Bronx-Lebanon Hospital Center, New York, 7Department of Medicine, Positive Health Program, San Francisco General Hospital, University of California San Francisco, 8Division of Infectious Diseases, Cooper University Hospital/UMDNJ-Robert Wood Johnson Medical School, Camden, NJ, and 9Yale School of Medicine, Yale New Haven Hospital, Yale University, New Haven, CT, US
PY - 2008/2
Y1 - 2008/2
N2 - A randomised trial compared two instruments for assessing self-reported adherence to antiretroviral medications: (1) a day-by-day recall instrument that elicited the number of missed doses in each of the prior three days (3-day instrument; n=64) and (2) a general recall instrument that elicited an estimate of proportion of pills taken during the prior seven days (7-day instrument; n=70). Adherence was measured at study visits over 12 months among participants in a clinical trial assessing treatment strategies for individuals with virologic failure and multidrug-resistant HIV. Participants had a median (interquartile range) of 133 (41-264) CD4 cells/ml3 and a median of 10 major HIV resistance mutations at baseline. Mean adherence levels were 90-98% throughout the study. There was a greater trend in the likelihood of 100% adherence when measured by the 3-day versus the 7-day instrument (odds ratio (OR)=1.45; p=0.06). The likelihood of consistent 100% adherence measured by either instrument decreased over time (p<0.001). Participants reporting 100% adherence at more than half of study visits had better virologic and immunologic outcomes at month-12 compared to those reporting 100% adherence at half or fewer visits (HIV RNA decline of 0.96 versus 0.51 log, respectively, p=0.02; and CD4 cell increase of 51.0 versus 17.8 cells, p=0.04). This study demonstrated the utility of the general 7-day recall adherence self-report instrument as well as the 3-day day-by-day recall adherence self-report instrument for measuring antiretroviral adherence. Self-reported adherence was significantly associated with virologic and immunologic outcomes in this population with advanced drug-resistant HIV disease.
AB - A randomised trial compared two instruments for assessing self-reported adherence to antiretroviral medications: (1) a day-by-day recall instrument that elicited the number of missed doses in each of the prior three days (3-day instrument; n=64) and (2) a general recall instrument that elicited an estimate of proportion of pills taken during the prior seven days (7-day instrument; n=70). Adherence was measured at study visits over 12 months among participants in a clinical trial assessing treatment strategies for individuals with virologic failure and multidrug-resistant HIV. Participants had a median (interquartile range) of 133 (41-264) CD4 cells/ml3 and a median of 10 major HIV resistance mutations at baseline. Mean adherence levels were 90-98% throughout the study. There was a greater trend in the likelihood of 100% adherence when measured by the 3-day versus the 7-day instrument (odds ratio (OR)=1.45; p=0.06). The likelihood of consistent 100% adherence measured by either instrument decreased over time (p<0.001). Participants reporting 100% adherence at more than half of study visits had better virologic and immunologic outcomes at month-12 compared to those reporting 100% adherence at half or fewer visits (HIV RNA decline of 0.96 versus 0.51 log, respectively, p=0.02; and CD4 cell increase of 51.0 versus 17.8 cells, p=0.04). This study demonstrated the utility of the general 7-day recall adherence self-report instrument as well as the 3-day day-by-day recall adherence self-report instrument for measuring antiretroviral adherence. Self-reported adherence was significantly associated with virologic and immunologic outcomes in this population with advanced drug-resistant HIV disease.
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U2 - 10.1080/09540120701534699
DO - 10.1080/09540120701534699
M3 - Article
C2 - 18293124
AN - SCOPUS:43249083005
SN - 0954-0121
VL - 20
SP - 161
EP - 169
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 2
ER -