Longitudinal trends and determinants of patient-reported side effects on ART-a Swedish national registry study.
Longitudinal trends and determinants of patient-reported side effects on ART-a Swedish national registry study.
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DOI：
10.1371/journal.pone.0242710
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Svedhem V
中科院分区：
文献类型：
--
作者：
Mellgren Å;Eriksson LE;Reinius M;Marrone G;Svedhem V
使用患者报告结局（PRO）系统量化不良事件（AE）将有助于改善HIV感染者（PLWH）的医疗护理和生活质量。本研究的目的是调查自我报告的副作用与其他PRO、人口统计学和实验室数据之间的关联，并进一步评估健康问卷（HQ）作为一种工具，用于跟踪患者报告的副作用随时间变化的趋势，与ART中处方的第三种药物的趋势有关。瑞典国家登记处InfCareHiv包括一份年度自我报告的9项HQ，用于患者-在瑞典所有艾滋病毒单位提供以艾滋病毒为中心的护理。在本研究中，讨论了副作用的经历。我们分析了由4，186名PLWH完成的9，476份HQ，以及2011-2017年期间收集的有关其处方ART和相关生物标志物的详细信息。资料以描述性统计、皮尔逊相关系数及混合逻辑回归分析。HQ的横断面分析显示，报告的副作用频率从32%（2011年）降至15%（2017年）。在同一时期，ART处方从依法韦仑（EFV）转变为度鲁特韦（DTG）（正相关系数r = 0.94，p = 0.0016）。此外，PLWH报告对他们的身体健康（OR：0.47，p = <0.001）或心理健康（OR：0.70，p = 0.001）感到满意的人比那些不太满意的人报告副作用的可能性更小。自我报告的副作用被发现与患者对其整体健康状况的评分密切相关，并与EFV使用的急剧下降和DTG使用的增加有很强的相关性，报告的副作用减半。本研究支持使用HQ作为PRO趋势纵向跟踪工具的可行性。
The use of patient-reported outcomes (PROs) to systematically quantify adverse events (AE) will assist in the improvement of medical care and the QoL of patients living with HIV (PLWH). The aim of this study was to investigate the associations between self-reported side effects and other PROs, demographics and laboratory data, and further evaluate the Health Questionnaire (HQ) as a tool for following trends in patient-reported side effects over time in relation to trends in prescribed third agent in ART. The Swedish National Registry InfCareHiv includes an annual self-reported nine-item HQwhich is used in patient-centered HIV care in all Swedish HIV units. In this study, the experience of side effects was addressed. We analyzed 9,476 HQs completed by 4,186 PLWH together with details about their prescribed ART and relevant biomarkers collected during 2011–2017. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient and mixed logistic regression. The cross-sectional analysis of the HQs showed that the frequency of reported side effects decreased from 32% (2011) to 15% (2017). During the same period, there was a shift in ART prescription from efavirenz (EFV) to dolutegravir (DTG) (positive correlation coefficient r = 0.94, p = 0.0016). Further, PLWH who reported being satisfied with their physical health (OR: 0.47, p = <0.001) or psychological health (OR: 0.70, p = 0.001) were less likely to report side effects than those less satisfied. Self-reported side effects were found to have a close relationship with the patient’s ratings of their overall health situation and demonstrated a strong correlation with the sharp decline in use of EFV and rise in use of DTG, with reported side effects being halved. This study supports the feasibility of using the HQ as a tool for longitudinal follow up of trends in PROs.
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