The adherence-outcome relationship is not altered by diary-driven adjustments of microelectronic monitor data
The adherence-outcome relationship is not altered by diary-driven adjustments of microelectronic monitor data
复制标题
DOI：
10.1002/pds.3887
复制
发表时间：
2015-12-01
影响因子：
2.6
通讯作者：
Lowenthal, Elizabeth
中科院分区：
文献类型：
--
作者：
Eby, Jessica;Chapman, Jennifer;Lowenthal, Elizabeth
目的 本研究的目的是确定基于支持信息对用药事件监测系统 (MEMS) 数据进行日记驱动的调整是否会加强测得的抗逆转录病毒药物依从性与血浆 HIV 病毒载量 (VL) 之间的关系。 方法 在 VL 测量之前，使用 MEMS 监测接受抗逆转录病毒治疗的 HIV+ 青少年 30 天。主要结果是 VL >= 400 拷贝/mL。使用手写日记全面记录与建议使用的偏差（打开瓶子但未服用剂量或未打开瓶子但服用剂量）。根据日记事件调整（“清理”）数据。数据“上限”为规定的剂量/天数。接收器操作员特征分析比较了 (i) 原始 MEMS 数据、(ii) 日记清理数据、(iii) 上限或 (iv) 清理和上限 MEMS 数据与 VL 之间的关系。 结果 在 VL 测量前 30 天内，273 名青少年发生了 465 件日记事件。与原始数据 (71.4%) 相比，封顶导致依从性达到 95% 的患者 (65.2%) 减少，p < 0.001。依从性与 VL 高度相关（OR 1.05，p < 0.001）。与 VL 相比，连续坚持的受试者工作特征曲线下面积为 0.89 (95% CI: 0.82-0.95)。日记清洁、封盖以及清洁和封盖 MEMS 数据均未显着改变依从性与 VL 之间的关联（分别为 p = 0.14、0.40 和 0.19）。 结论 基于日记条目的药物事件监测系统数据清理不会影响依从性与 VL 关系。版权所有 (C) 2015 约翰·威利父子有限公司
Purpose The purpose of this study was to determine whether diary-driven adjustment of Medication Event Monitoring System (MEMS) data based on Supporting Information strengthens the relationship between measured antiretroviral medication adherence and plasma HIV viral load (VL).Methods HIV+ adolescents on antiretroviral treatment were monitored with MEMS for 30 days preceding a VL measurement. The primary outcome was VL >= 400 copies/mL. Handwritten diaries were used to comprehensively record deviations from recommended use (bottle opened but dose not taken or bottle not opened and dose taken). Data were adjusted ("cleaned") based on diary events. Data were "capped" at the prescribed number of doses/day. Receiver operator characteristic analysis compared the relationships between (i) raw MEMS data, (ii) diary-cleaned, (iii) capped, or (iv) cleaned and capped MEMS data and VL.Results Over 30 days preceding VL measurements, 273 adolescents had 465 diary events. Capping resulted in fewer patients classified as 95% adherent (65.2%) compared with raw data (71.4%), p < 0.001. Adherence was highly associated with VL (OR 1.05, p < 0.001). The area under the receiver operating characteristic curve for continuous adherence compared with VL was 0.89 (95%CI: 0.82-0.95). Neither diary-cleaning, capping, nor cleaning and capping MEMS data significantly altered the association between adherence and VL (p = 0.14, 0.40, and 0.19, respectively).Conclusion Medication Event Monitoring System data-cleaning based on diary entries did not affect the adherence-VL relationship. Copyright (C) 2015 John Wiley & Sons, Ltd.