Comprehensive evaluation of caregiver-reported antiretroviral therapy adherence for HIV-infected children.

Comprehensive evaluation of caregiver-reported antiretroviral therapy adherence for HIV-infected children.
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对艾滋病毒感染儿童的护理人员报告的抗逆转录病毒疗法的全面评估。

DOI:
10.1007/s10461-015-0998-x
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发表时间:
2015-04
期刊:
影响因子:
4.4
通讯作者:
Inui, Thomas S.
Inui, Thomas S.
中科院分区:
医学2区
文献类型:
--
作者:
Vreeman, Rachel C.;Nyandiko, Winstone M.;Liu, Hai;Tu, Wanzhu;Scanlon, Michael L.;Slaven, James E.;Ayaya, Samuel O.;Inui, Thomas S.

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对于HIV感染儿童,抗逆转录病毒治疗(ART)的依从性通常由非正式报告评估,但其有效性的数据很少。我们对肯尼亚西部191名0至14岁的儿童及其6个月以上的照顾者进行了前瞻性评估,以确定最能预测ART依从性的问卷项目。使用药物事件监测系统®(MEMS,MWV/AARDEX Ltd,瑞士)电子剂量监测仪作为依从性的外部标准。我们采用了一种新的变量选择工具,使用LASSO技术和逻辑回归来识别与二分MEMS依从性(≥90%或<90%服用剂量)最相关的项目。48个依从性项目中有9个被确定为依从性的最佳预测因素,包括过去7天内错过或延迟给药,给孩子药物的问题,以及其他水平的因素,如不存在服药。这些项目可以包括在儿科患者的依从性评估工具中。
For HIV-infected children, adherence to antiretroviral therapy (ART) is often assessed by caregiver-report but there are few data on their validity. We conducted prospective evaluations with 191 children ages 0 to 14 years and their caregivers over 6 months in western Kenya to identify questionnaire items that best predicted adherence to ART. Medication Event Monitoring Systems® (MEMS, MWV/AARDEX Ltd, Switzerland) electronic dose monitors were used as external criterion for adherence. We employed a novel variable selection tool using the LASSO technique with logistic regression to identify items best correlated with dichotomized MEMS adherence (≥90% or <90% doses taken). Nine of 48 adherence items were identified as the best predictors of adherence, including missed or late doses in the past 7 days, problems giving the child medicines, and caregiver-level factors like not being present at medication taking. These items could be included in adherence assessment tools for pediatric patients.
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