Spillover adherence effects of fixed-dose combination HIV therapy
Spillover adherence effects of fixed-dose combination HIV therapy
复制标题
DOI：
10.2147/ppa.s28482
复制
发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Davis, E. Anne
中科院分区：
文献类型：
--
作者：
Kauf, Teresa L.;Davis, Keith L.;Davis, E. Anne
尚未检查固定剂量复方制剂（FDC）产品对其他非固定方案组分依从性的影响。我们比较了接受核苷类逆转录酶抑制剂（NRTI）骨架的患者对第三种抗逆转录病毒（ART）成分的依从性，NRTI骨架由FDC Epzicom（R），GlaxoSmithKline Inc，Research Triangle Park，NC组成（硫酸阿巴卡韦600 mg+拉米夫定300 mg; FDC组）与作为两种单独药丸服用的NRTI组合（NRTI组合组）使用的数据来自全国样本的30个健康计划，涵盖约3800万人的生命，从1997年至2005年。依从性以药物持有率（MPR）衡量。多变量逻辑回归基于实现> 95%依从性的可能性比较治疗组，敏感性分析使用替代阈值。MPR作为一个连续变量，使用多元线性回归进行评估。协变量包括年龄、性别、保险支付人类型、研究药物开始使用年份、存在精神健康和药物滥用障碍以及第三类药物。研究样本包括650例FDC和1947例NRTI Combo患者。FDC组对第三种药物的未校正平均依从性高于NRTI Combo组（0.92 vs 0.85; P <0.0001）。在回归分析中，FDC患者分别有48%和39%的可能性达到95%和90%的第三药物依从性（P
The impact of fixed-dose combination (FDC) products on adherence to other, non-fixed regimen components has not been examined. We compared adherence to a third antiretroviral (ART) component among patients receiving a nucleoside reverse transcriptase inhibitor (NRTI) backbone consisting of the FDC Epzicom (R), GlaxoSmithKline Inc, Research Triangle Park, NC (abacavir sulfate 600 mg + lamivudine 300 mg; FDC group) versus NRTI combinations taken as two separate pills (NRTI Combo group) using data from a national sample of 30 health plans covering approximately 38 million lives from 1997 to 2005. Adherence was measured as the medication possession ratio (MPR). Multivariate logistic regression compared treatment groups based on the likelihood of achieving >95% adherence, with sensitivity analyses using alternative thresholds. MPR was assessed as a continuous variable using multivariate linear regression. Covariates included age, gender, insurance payer type, year of study drug initiation, presence of mental health and substance abuse disorders, and third agent class. The study sample consisted of 650 FDC and 1947 NRTI Combo patients. Unadjusted mean adherence to the third agent was higher in the FDC group than the NRTI Combo group (0.92 vs 0.85; P < 0.0001). In regression analyses, FDC patients were 48% and 39% more likely to achieve 95% and 90% third agent adherence, respectively (P