Adherence in AIDS clinical trials: A framework for clinical research and clinical care
Adherence in AIDS clinical trials: A framework for clinical research and clinical care
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DOI：
10.1016/s0895-4356(97)00041-3
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发表时间：
1997-04-01
影响因子：
7.2
通讯作者：
Meisler, AW
中科院分区：
文献类型：
--
作者：
Ickovics, JR;Meisler, AW
艾滋病临床试验中的依从性评估是成功评估治疗结果的关键组成部分。药物依从性差可能导致对临床试验数据的误解。对艾滋病临床试验依从性影响因素的研究很少，也很少有研究评估提高患者参与的策略。其中一个原因可能是缺乏指导研究的概念框架。与之前关于医疗依从性的研究一致，我们提出了一个框架，根据该框架，艾滋病临床试验中影响依从性的因素可以分为：(a)个人，(b)治疗方案，(c)医患关系，(d)临床环境和(e)疾病的特征。这个框架被用来作为一个启发式审查研究，检查艾滋病临床试验中影响依从性的因素。对今后的研究和临床干预提出了建议。这些努力是及时的，因为依从性现在是关于新型蛋白酶抑制剂药物疗效的话语关注的中心；不依从性与病毒耐药性和药物失败有关。努力确定影响艾滋病临床试验依从性的因素，可以为今后提高依从性和保留性的尝试提供信息。更好的依从性保护了艾滋病临床试验的科学完整性，促进了更有效和准确的治疗价值评估。随后可能会加速获得新的治疗方法，最终提高患者的护理水平。(C) 1997爱思唯尔科学有限公司
Assessment of adherence within AIDS clinical trials is a critical component of the successful evaluation of therapeutic outcomes. Poor medication adherence can result in the misinterpretation of clinical trial data. Research on factors affecting adherence in AIDS clinical trials has been scarce, and few investigations have evaluated strategies for enhancing patient participation. One reason may be the absence of a conceptual framework to guide research. Consistent with previous research on medical adherence, we propose a framework whereby factors affecting adherence in AIDS clinical trials can be categorized as characteristics of the: (a) individual, (b) treatment regimen, (c) patient-provider relationship, (d) clinical setting, and (e) disease. This framework is used as a heuristic for reviewing studies that examine factors affecting adherence in AIDS clinical trials. Suggestions for future research and clinical intervention are provided.These efforts are timely because adherence is now the center of attention in discourse about the efficacy of the new class of protease inhibitor drugs; non-adherence has been linked to viral resistance and drug failure. Efforts to identify factors that influence adherence to AIDS clinical trials can inform future attempts to improve adherence and retention. Better adherence protects the scientific integrity of AIDS clinical trials, promoting more efficient and accurate evaluations of therapeutic value. Accelerated access to new treatments may follow, ultimately enhancing patient care. (C) 1997 Elsevier Science Inc.