Impact of Pill Burden on Adherence, Risk of Hospitalization, and Viral Suppression in Patients with HIV Infection and AIDS Receiving Antiretroviral Therapy
Impact of Pill Burden on Adherence, Risk of Hospitalization, and Viral Suppression in Patients with HIV Infection and AIDS Receiving Antiretroviral Therapy
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DOI：
10.1002/phar.1728
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发表时间：
2016-04-01
期刊：
影响因子：
4.1
通讯作者：
Hardin, James W.
中科院分区：
文献类型：
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作者：
Sutton, S. Scott;Magagnoli, Joseph;Hardin, James W.
研究目的评估药物负担对人类免疫缺陷病毒（HIV）感染和获得性免疫缺陷综合症（AIDS）患者接受抗逆转录病毒治疗（ART）作为单片方案（STR）或多片方案（MTR）的结果的影响。设计回顾性队列研究。数据来源南卡罗来纳州医疗补助医疗和药房付费索赔数据来自南卡罗来纳州收入和财政事务办公室；实验室数据来自南卡罗来纳州健康和环境控制部。患者南卡罗来纳州医疗补助覆盖的总共 2174 名患者在 2006 年 1 月 1 日至 2013 年 12 月 31 日期间接受了持续至少 60 天的完整 ART STR（580 名患者）或 MTR（1594 名患者）。住院的风险、时间和总人数；和病毒载量抑制。从索引日期（完整 ART 治疗方案的开始日期）开始对患者进行随访，直至出现以下情况之一的最早日期：治疗停止；治疗从 MTR 转换为 STR，反之亦然；学习期结束；医疗补助资格的最后日期；或死亡。通过使用双变量 (2) 和 Wilcoxon 秩和检验以及控制 6 个月基线期间测量的协变量的多变量回归模型来评估结果差异。平均而言，STR 和 MTR 队列在指数日期年龄、查尔森合并症指数评分、性别、药物滥用和心理健康诊断方面相似，但在种族构成、治疗指数年份、既往治疗、基线病毒载量和 CD4 测量方面存在显着差异。双变量分析显示 STR 队列的依从性更强 (p
Study ObjectiveTo evaluate the impact of pill burden on outcomes in patients with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) receiving antiretroviral therapy (ART) as a single-tablet regimen (STR) or multiple-tablet regimen (MTR).DesignRetrospective cohort study.Data SourcesSouth Carolina Medicaid medical and pharmacy paid claims data were obtained from the South Carolina Revenue and Fiscal Affairs Office; laboratory data were obtained from the South Carolina Department of Health and Environmental Control.PatientsA total of 2174 patients covered by South Carolina Medicaid who were dispensed a complete ART STR (580 patients) or MTR (1594 patients) lasting at least 60days between January 1, 2006, and December 31, 2013.Measurements and Main ResultsOutcomes were ART adherence; risk of, time to, and total number of hospitalizations; and viral load suppression. Patients were followed from the index date (start date of their complete ART regimen) until the earliest date of one of the following: treatment discontinuation; treatment switch from MTR to STR, or vice versa; end of study period; last date of Medicaid eligibility; or death. Differences in outcomes were evaluated by using bivariate (2) and Wilcoxon rank sum tests, as well as multivariate regression models controlling for covariates measured during a 6-month baseline period. The STR and MTR cohorts were, on average, similar in terms of age at index date, Charlson Comorbidity Index score, sex, drug abuse, and mental health diagnoses, but they differed significantly in racial composition, index year of regimen, previous treatment, baseline viral load, and CD4 measures. The bivariate analysis revealed that the STR cohort was more adherent (p