Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users
Factors associated with antiretroviral therapy adherence and medication errors among HIV-infected injection drug users
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DOI：
10.1097/qai.0b013e31815767d6
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发表时间：
2007-11-01
影响因子：
3.6
通讯作者：
Metsch, Lisa R.
中科院分区：
文献类型：
--
作者：
Arnsten, Julia H.;Li, Xuan;Metsch, Lisa R.
背景资料：积极的药物使用往往与不良的依从性，但很少有研究确定的心理社会相关的注射吸毒者（IDUs）的依从性。方法：1161干预血清阳性注射者研究和评价研究登记，636正在服用抗逆转录病毒药物。我们评估了自我报告的坚持自我报告的抗逆转录病毒治疗方案和用药错误，我们定义为每日剂量，不符合标准或替代antiretroviral prescription.Results：大多数受试者（75%，n = 477）自我报告良好（>= 90%）的遵守，这是与不可检测的病毒载量密切相关。良好的依从性与高中毕业生、不共用注射设备、抑郁症状较少、对抗逆转录病毒药物的积极态度、按处方服用抗逆转录病毒药物的自我效能较高以及保护他人免受HIV感染的责任感更强独立相关。54%（n = 346）的患者出现用药错误，与可检测的病毒载量和较少的CD4细胞密切相关。错误独立与非白人种族和抑郁症状，自我效能差，更安全的药物使用，以及对艾滋病药物的态度差。结论：可修改的因素与依从性差，包括抑郁症状和自我效能差，应针对干预。由于用药错误是普遍存在的，并与可检测的病毒载量和较少的CD4细胞，干预措施应包括特别努力，以确定药物服用不符合抗逆转录病毒处方。
Background: Active drug use is often associated with poor adherence, but few studies have determined psychosocial correlates of adherence in injection drug users (IDUs).Methods: Of 1161 Intervention for Seropositive Injectors-Research and Evaluation study enrollees, 636 were taking antiretrovirals. We assessed self-reported adherence to self-reported antiretroviral regimens and medication errors, which we defined as daily doses that were inconsistent with standard or alternative antiretroviral prescriptions.Results: Most subjects (75%, n = 477) self-reported good (>= 90%) adherence, which was strongly associated with an undetectable viral load. Good adherence was independently associated with being a high school graduate, not sharing injection equipment, fewer depressive symptoms, positive attitudes toward antiretrovirals, higher self-efficacy for taking antiretrovirals as prescribed, and greater sense of responsibility to protect others from HIV Medication errors were made by 54% (n = 346) and were strongly associated with a detectable viral load and fewer CD4 cells. Errors were independently associated with nonwhite race and with depressive symptoms, poorer self-efficacy for safer drug use, and worse attitudes toward HIV medications.Conclusions: Modifiable factors associated with poor adherence, including depressive symptoms and poor self-efficacy, should be targeted for intervention. Because medication errors are prevalent and associated with a detectable viral load and fewer CD4 cells, interventions should include particular efforts to identify medication taking inconsistent with antiretroviral prescriptions.