Correlates of Antiretroviral and Antidepressant Adherence Among Depressed HIV-Infected Patients
Correlates of Antiretroviral and Antidepressant Adherence Among Depressed HIV-Infected Patients
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DOI：
10.1089/apc.2011.0218
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发表时间：
2012-05-01
影响因子：
4.9
通讯作者：
Pyne, Jeffrey M.
中科院分区：
文献类型：
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作者：
Bottonari, Kathryn A.;Tripathi, Shanti P.;Pyne, Jeffrey M.
虽然药物治疗的疗效至关重要，但坚持抗逆转录病毒药物和抗抑郁药物的处方药物治疗方案往往是次优的。由于许多抑郁的HIV感染者同时服用抗逆转录病毒药物和抗抑郁药物，因此了解不同类型的治疗方案中不依从性的相关因素是否相似或不同是很重要的。HIV将抑郁症转化为有效解决方案（HI-TIDES）研究是一项单盲，纵向，随机对照有效性试验，比较了三个退伍军人事务部HIV诊所的协作护理与常规抑郁症护理。目前的调查使用自我报告基线访谈和图表摘要数据。参与者是225名抑郁的HIV感染患者，他们被开了抗抑郁药（n = 146），抗逆转录病毒药物（n = 192）或两者兼而有之（n = 113）。过去4天内的治疗依从性分为“依从性低于90%”或“依从性≥ 90%”。在确定了不依从的潜在相关性后，我们使用了一个看似不相关的回归（SUR）双变量概率模型，其中对HIV药物依从性的概率和抗抑郁药物依从性的概率联合建模。结果表明，75.5%（n = 146）的抗逆转录病毒药物处方的依从性超过90%，76.7%（n = 112）的抗抑郁药物处方的依从性超过90%，而67%（n = 113）的抗抑郁药物处方的依从性超过90%。SUR结果表明，教育，年龄和艾滋病毒症状的严重程度显着相关的抗逆转录病毒药物的依从性，而性别和广泛性焦虑症的诊断是显着相关的抗抑郁药物的依从性。此外，抗逆转录病毒药物依从性不能预测抗抑郁药依从性（β = 1.62，p = 0.17），但是，抗抑郁药依从性确实预测抗逆转录病毒药物依从性（β = 2.30，p < 0.05）。
Although crucial for efficacy of pharmacotherapy, adherence to prescribed medication regimens for both antiretrovirals and antidepressants is often suboptimal. As many depressed HIV-infected individuals are prescribed both antiretrovirals and antidepressants, it is important to know whether correlates of nonadherence are similar or different across type of regimen. The HIV Translating Initiatives for Depression into Effective Solutions (HI-TIDES) study was a single-blinded, longitudinal, randomized controlled effectiveness trial comparing collaborative care to usual depression care at three Veterans Affairs HIV clinics. The current investigation utilized self-report baseline interview and chart-abstracted data. Participants were 225 depressed HIV-infected patients who were prescribed an antidepressant (n = 146), an antiretroviral (n = 192), or both (n = 113). Treatment adherence over the last 4 days was dichotomized as "less than 90% adherence'' or "90% or greater adherence.'' After identifying potential correlates of nonadherence, we used a seemingly unrelated regression (SUR) bivariate probit model, in which the probability of adherence to HIV medications and the probability of adherence to antidepressant medications are modeled jointly. Results indicated that 75.5% (n = 146) of those prescribed antiretrovirals reported 90%-plus adherence to their antiretroviral prescription and 76.7% (n = 112) of those prescribed antidepressants reported 90%-plus adherence to their antidepressant prescription, while 67% of those prescribed both (n = 113) reported more than 90% adherence to both regimens. SUR results indicated that education, age, and HIV symptom severity were significant correlates of antiretroviral medication adherence while gender and generalized anxiety disorder diagnosis were significant correlates of adherence to antidepressant medications. In addition, antiretroviral adherence did not predict antidepressant adherence (beta = 1.62, p = 0.17), however, antidepressant adherence did predict antiretroviral adherence (beta = 2.30, p < 0.05).