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Self-reporting of Adherence Correlates with Pharmacy Records and
Is Practical for Use in Routine Clinical Care
The
current study compares long-term adherence to antiretroviral therapy in an HIV service,
as measured by self-report and by pharmacy records and determines
the level of adherence by each measure required to suppress HIV
viral load in
a majority of patients.
The percentage of prescribed doses taken
was calculated from (a) the number of missed doses in the previous
28 days reported by patients in a questionnaire at each clinic visit,
and (b) pharmacy dispensing records. These were compared with each
other and with HIV viral load data.
Results
· Mean adherence
was 96.2% by pharmacy record over 44 months and 98.6% by self-report
over 25 months.
· The two methods
correlated with each other (P<0.001) and the proportion
of patients with viral load <400 HIV-1 RNA copies/mL increased
with adherence as measured by self-report (P=0.001) and pharmacy
record (P=0.004).
·
Fewer than 60% of patients always had viral loads <400 copies/mL
if adherence fell below 95% (pharmacy record) or 97% (self-report).
· Adherence
was higher for once-daily than for twice-daily therapy (by pharmacy
record: 97.2% vs. 96.0%; P<0.001).
· Adherence
by both measures increased over time.
In conclusion, the authors write, “Self-reported antiretroviral adherence correlates with pharmacy dispensing
records and predicts suppression of viral load at levels >/=
97%. It is practical to adopt this into routine HIV clinical care.
09/23/05
Reference
C K Fairley and others. Long-term utility of measuring adherence by self-report compared with pharmacy
record in a routine clinic setting. HIV Medicine 6(5):
366. September 2005.
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