Patterns of adherence to antiretroviral medications: the value of electronic monitoring
Patterns of adherence to antiretroviral medications: the value of electronic monitoring
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DOI：
10.1097/00002030-200308150-00005
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发表时间：
2003-08-15
期刊：
影响因子：
3.8
通讯作者：
Ross, J
中科院分区：
文献类型：
--
作者：
McNabb, JJ;Nicolau, DP;Ross, J
目的：要调查的模式内的主题（药物之间）坚持antiretroviral therapeutic.Design：一个前瞻性的，观察性的，3个月的研究，坚持抗逆转录病毒疗法在内城诊所在40 HIV infected subjects.Methods：坚持每月监测使用的药物事件监测系统（Aprex）帽放置在每个抗逆转录病毒药物在受试者的方案。通过估计依从性的平均差异（95%的一致性限度），对每例受试者的不同药物类别和给药方案之间的一致性进行量化。使用方差分析模型估计差异的方差。个别的给药日历进行了检查，为每个subject.Results：给药时间表是一个很强的预测受试者内的依从性。无论受试者的总体依从率是高还是低，当受试者漏服一种药物时，他们在该给药时间漏服两种药物。相反，当药物计划一起服用时，无论药物类别如何，药物都在同一时间服用。大多数受试者在明显不正确的时间服用药物。有问题的坚持与每日三次给药和食物restrictions.Conclusion：这是第一份报告客观地量化受试者内坚持抗逆转录病毒治疗，并报告详细的调查结果。我们在研究对象中观察到了明确的吸毒行为模式。在某种程度上，药物治疗计划是一个可控的因素，我们的报告提供了一个深入了解特定的行为模式，可能是目标的依从性咨询。(C)2003年利平科特威廉姆斯威尔金斯。
Objective: To investigate the patterns of intra-subject (between medication) adherence to antiretroviral therapy.Design: A prospective, observational, 3-month study of adherence to antiretroviral therapy at an inner-city clinic in 40 HIV-infected subjects.Methods: Adherence was monitored monthly by the use of medication event monitoring system (Aprex) caps placed on each antiretroviral drug in a subject's regimen. Agreement between different drug classes and dosing schedules, for each subject, was quantified by estimating the mean difference in adherence, with 95% limits of agreement. An analysis of variance model was used to estimate the variance of the differences. individual dosing calendars were examined for each subject.Results: The dosing schedule was a strong predictor of intra-subject adherence. Regardless of the subject's overall adherence rate, high or low, when subjects missed a dose of one medication, they missed a dose of both medications taken at that dosing time. Conversely, when medications were scheduled to be taken together, regardless of the drug class, the medications were taken at the same times. The majority of the subjects took medications at obviously incorrect times. Problematical adherence was related to thrice-daily dosing and food restrictions.Conclusion: This is the first report objectively to quantify intra-subject adherence to antiretroviral therapy and report the findings in detail. We observed clear patterns of drug-taking behavior among the subjects in our study. To the extent that medication scheduling is a controllable factor, our report provides an insight into specific patterns of behavior that may be targets for adherence counseling. (C) 2003 Lippincott Williams Wilkins.