Assessment of adherence to HIV protease inhibitors: Comparison and combination of various methods, including MEMS (electronic monitoring), patient and nurse report, and therapeutic drug monitoring
Assessment of adherence to HIV protease inhibitors: Comparison and combination of various methods, including MEMS (electronic monitoring), patient and nurse report, and therapeutic drug monitoring
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DOI：
10.1097/01.qai.0000014768.35851.db
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发表时间：
2002-07-01
期刊：
影响因子：
--
通讯作者：
Hekster, YA
中科院分区：
文献类型：
--
作者：
Hugen, PWH;Langebeek, N;Hekster, YA
背景：对含酶抑制剂的抗逆转录病毒治疗的依从性至关重要，但难以衡量。目的：比较和结合各种测量依从性的方法。方法：用药事件监测系统(MEMS)CAPS(电子监测)。治疗性药物监测、药片计数、药房续药数据。问卷调查。日记(用于登记与使用MEMS有关的食物模式和特殊事件)。由医生和临床护士专家进行依从性评估，并进行深入访谈。结果：共纳入28例患者，其中26例可评价数据。根据MEMS的数据，25%的患者服用的剂量不到所有剂量的95%。三分之二的患者按时服用的剂量不到95%。只有4311名患者对饮食限制表现出良好的依从性。与MEMS结果显著相关的方法是患者自我报告的依从性治疗药物监测，表明血浆水平超出预定范围，以及临床护士专家对依从性的评估，特别是通过深入访谈，结论：经过日记校正的MEMS数据可以详细了解患者的依从性模式。患者的自我报告和治疗药物监测与MEMS数据显著相关，临床护理专家也可能计划在识别患者不完全依从性方面发挥作用。
Background: Adherence to protease inhibitor-containing antiretroviral therapy is crucial, but difficult to measure.Objective: To compare and combine various methods of measuring adherence to the strict protease inhibitor-containing regimens.Methods: The following methods were used: medication event monitoring system (MEMS) caps (electronic monitoring). therapeutic drug monitoring, pill count, pharmacy refill data. questionnaires. diaries (for registration of food patterns and special events related to the use of MEMS). adherence assessment by the physician and clinical nurse specialist, and in-depth interviews, In addition. ultrasensitive viral load and resistance testing was performed.Results: Twenty-eight patients were included: data Could he evaluated in 26. According to MEMS data, 25% of the patients took fewer than 95% of all doses. and two thirds of the patients took fewer than 95% of the doses on time. Only 4311 of the patients showed good adherence with food restrictions. Methods that showed significant correlations with MEMS results were patients' self-reported adherence therapeutic drug monitoring, indicating plasma levels outside predefined ranges and estimation of adherence by a clinical nurse specialist, especially by in-depth interview,Conclusion: Diary-corrected MEMS data gave a detailed insight into patients' adherence patterns. Patients' self-report and therapeutic drug monitoring were significantly correlated with the MEMS data, and the clinical nurse specialist may also plan a role in identifying patients who are imperfectly adherent.