Using Different Calculations of Pharmacy Refill Adherence to Predict Virological Failure Among HIV-Infected Patients
Using Different Calculations of Pharmacy Refill Adherence to Predict Virological Failure Among HIV-Infected Patients
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DOI：
10.1097/qai.0b013e3181fba6ab
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发表时间：
2010-12-15
影响因子：
3.6
通讯作者：
Nieuwkerk, Pythia T.
中科院分区：
文献类型：
--
作者：
de Boer, I. Marion;Prins, Jan M.;Nieuwkerk, Pythia T.
背景：重新填充数据越来越多地用于评估HIV感染患者联合抗逆转录病毒治疗的依从性。然而，当涉及多家药店时，这种方法的可行性尚不清楚。此外，包括以前续药后的剩余药物和规定的治疗时间对依从性计算的影响尚不清楚。我们在本研究中解决了这些问题。方法：在阿姆斯特丹学术医学中心的门诊招募成年HIV-1感染患者，并询问他们的药店名称。再灌装数据来自药房。计算了在不考虑剩余药物和处方治疗中断时被错误归类为未依从者的患者的百分比。最后，我们调查了所有药物的平均依从性计算或基于方案中一种药物的计算是否最能预测病毒学失败(血浆HIV-1RNA和GT；40拷贝/毫升)。结果：纳入201名患者。从多家药店(132家)收集数据被发现是可行的。43%的患者在无视剩余药物时被错误归类为不依从者，2%的患者在无视规定的治疗时间时被错误归类为未依从者。通过不同的粘附性计算来预测病毒学失败没有差别。结论：这些发现建议使用药房重新灌装数据的研究应该包括剩余的药物。
Background: Refill data are increasingly used to assess adherence in HIV-infected patients on combination antiretroviral therapy. However, it is not clear how feasible this method is when multiple pharmacies are involved. Also, the effects of inclusion of leftover medication from previous refills and prescribed treatment time on adherence calculations are unknown. We addressed these questions in the present study.Methods: Adult HIV-1-infected patients were recruited at the outpatient clinic of the Academic Medical Centre in Amsterdam and asked for their pharmacies' names. Refill data were obtained from pharmacies. Percentages of patients misclassified as nonadherent when disregarding leftover medication and prescribed treatment interruptions were calculated. Finally, we investigated whether an average adherence calculation of all drugs or a calculation based on one drug in the regimen best predicted virological failure (plasma HIV-1 RNA >40 copies/mL).Results: Two hundred one patients were included. Collecting data from multiple pharmacies (132) was found to be feasible. Forty-three percent of patients were misclassified as nonadherent when disregarding leftover medication and 2 percent when disregarding prescribed treatment time. There was no difference in predicting virological failure by different calculations of adherence.Conclusions: These findings suggest that studies using pharmacy refill data should include leftover medication.