Practical and conceptual challenges in measuring antiretroviral adherence
Practical and conceptual challenges in measuring antiretroviral adherence
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DOI：
10.1097/01.qai.0000248337.97814.66
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发表时间：
2006-12-01
影响因子：
3.6
通讯作者：
Arnsten, Julia H.
中科院分区：
文献类型：
--
作者：
Berg, Karina M.;Arnsten, Julia H.
准确测量抗逆转录病毒治疗依从性对于确定干预措施的目标和严格评估干预措施以提高依从性和预防病毒耐药性至关重要。在各种疾病中，药物依从性是一种个体、复杂和动态的人类行为，提出了独特的测量挑战。药物依从性的测量由于可用测量的多样性而进一步复杂化，这些测量在临床和研究环境中具有不同的效用。对如何优化现有依从性措施的了解有限，阻碍了艾滋病毒和其他疾病依从性研究的进展。虽然自我报告是最广泛使用的依从性措施，最有希望用于临床护理和资源有限的设置，依从性研究人员还没有制定基于证据的标准，自我报告的依从性。此外，使用客观的措施，如电子药物监测或药丸计数，是有限的，因为缺乏对这些措施的来源和误差程度的理解。为了克服这些局限性，需要开展研究，以评估将不同计量办法的信息结合起来的方法。本综述的目的是描述依从性测量的科学状态，讨论常见的依从性测量方法的优点和缺点，并建议在研究和临床护理中改进抗逆转录病毒药物依从性测量的方向。
Accurate measurement of antiretroviral adherence is essential for targeting and rigorously evaluating interventions to improve adherence and prevent viral resistance. Across diseases, medication adherence is an individual, complex, and dynamic human behavior that presents unique measurement challenges. Measurement of medication adherence is further complicated by the diversity of available measures, which have different utility in clinical and research settings. Limited understanding of how to optimize existing adherence measures has hindered progress in adherence research in HIV and other diseases. Although self-report is the most widely used adherence measure and the most promising for use in clinical care and resource-limited settings, adherence researchers have yet to develop evidence-based standards for self-reported adherence. In addition, the use of objective measures, such as electronic drug monitoring or pill counts, is limited by poor understanding of the source and magnitude of error biasing these measures. To address these limitations, research is needed to evaluate methods of combining information from different measures. The goals of this review are to describe the state of the science of adherence measurement, to discuss the advantages and disadvantages of common adherence measurement methods, and to recommend directions for improving antiretroviral adherence measurement in research and clinical care.