Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection
Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection
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DOI：
10.1097/00042560-200112150-00006
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发表时间：
2001-12-15
期刊：
影响因子：
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通讯作者：
Antinori, A
中科院分区：
文献类型：
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作者：
Ammassari, A;Murri, R;Antinori, A
目的：为了确定预测不依从高效抗逆转录病毒治疗（HAART）的变量，并评估自我报告的症状或药物副作用是否与依从性有关。设计：在意大利队列初治抗逆转录病毒药物（ICONA）中进行的横断面多中心研究依从性意大利队列初治抗逆转录病毒药物[AdICONA]。方法：接受HAART的参与者完成了一份16项自填问卷，以评估过去3天内的不依从性以及24种常见HIV和HAART的类型和强度。结果：从1999年5月至2000年3月，共纳入358人，其中22%的人报告不依从，HIV RNA < 500拷贝的可能性较小（OR = 0.51，95%可信区间：0.31-0.85）。不依从参与者中中度/重度症状或药物副作用的频率范围为3.6%至30%，单变量分析显示，恶心、焦虑、意识模糊、视力问题、厌食、失眠、味觉倒错和脂肪分布异常与不依从显着相关。与依从性受试者相比，不依从性受试者的平均总体症状评分（12.3 +/- 91 vs 8.1 +/- 6.6; p <0.001）和平均药物副作用评分（2.9 +/- 2.7 vs 1.9 +/- 1.9; p <0.001）更高。在多变量分析中，恶心（p = .003）;焦虑（p = .006）;年龄较小（p = .007）;失业（p < .001）;不记得药物的名称、颜色和时间（p = .009）;访视之间的药丸用完（p < .002）;以及过于忙碌（p = .03）与过去3天内的不依从性独立相关。除了患者特征、药物相关变量和不依从原因外，患者报告的症状和药物副作用与HAART依从性显著相关。
Objectives: To identify variables predictive of nonadherence to highly active antiretroviral therapy (HAART) and to assess whether self-reported symptoms or medication side effects are related to adherence.Design: Cross-sectional multicenter study Adherence Italian Cohort Naive Antiretrovirals [AdICONA] within the Italian Cohort Naive Antiretrovirals (ICONA).Methods: Participants receiving HAART completed a 16-item self-administered questionnaire to assess nonadherence in the last 3 days as well as the type and intensity of 24 common HIV- and HAART-related symptoms experienced during the last 4 weeks.Results: From May 1999 to March 2000, 358 persons were enrolled: 22% reported nonadherence and were less likely to have HIV RNA < 500 copieshnl (odds ratio = 0.51; 95% confidence interval: 0.31-0.85). Frequency of moderate/severe symptoms or medication side effects in nonadherent participants ranged from 3.6% to 30%, On univariate analysis, nausea, anxiety, confusion, vision problems, anorexia, insomnia, taste perversion, and abnormal fat distribution were significantly associated with nonadherence. Nonadherent persons had a higher mean overall symptom score (12.3 +/- 91 versus 8.1 +/- 6.6; p < .001) and mean medication side effect score (2.9 +/- 2.7 versus 1.9 +/- 1.9; p < .001) when compared with adherent participants. In the multivariate analysis, nausea (p = .003); anxiety (p = .006); younger age (p = .007); unemployment (p < .001); not recalling name, color, and timing of drugs (p = .009); running out of pills between visits (p < .002); and being too busy (p = .03) were independently associated with nonadherence in the last 3 days.Conclusions: In addition to patient characteristics, medication-related variables, and reasons for nonadherence, patient-reported symptoms and medication side effects were significantly associated with adherence to HAART.