Assessing adherence in Thai patients taking combination antiretroviral therapy

International Journal of STD & AIDS
S J KerrC Duncombe

Abstract

In settings where medications and viral load (VL) monitoring are limited by cost, clinicians need reliable ways to assess patient adherence to therapy. We assessed sensitivity and specificity of two self-reported adherence tools (a visual analogue scale [VAS] and the CASE [Center for Adherence Support Evaluation] adherence index), against a standard of detectable VL, with 288 patients from three sites in Thailand. We also assessed predictors of non-adherence. The sensitivity and specificity of the VAS <95% and CASE adherence index ≤11 against a VL >50 copies/mL were 26% and 90%, 19% and 95%, respectively. Against a VL ≥1000 copies/mL sensitivities increased to 55% and 36%, respectively, and specificities were unchanged. Attending a clinic not staffed by HIV specialists (odds ratio [OR] 3.14; 95% confidence interval [CI] 1.19-8.34) and being educated to primary school level or less (OR 2.24; 95% CI 1.01-4.94) were associated with self-reported adherence <95% on the VAS in multivariate analysis. Adherence assessed by the VAS was a more accurate predictor of detectable VL. Policy-makers in resource-limited settings should ensure that treatment centres are staffed with well-trained personnel aware of the importance of good patient ...Continue Reading

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Citations

Sep 25, 2014·BMC Public Health·Heather BaileyUNKNOWN Ukraine European Collaborative Study Group in EuroCoord
Jun 30, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Wasana PrasitsuebsaiAnnette H Sohn
May 31, 2013·Journal of the International Association of Providers of AIDS Care·Howard Newville, James L Sorensen
Dec 9, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Stella BabalolaMaria-Elena Figueroa
Oct 9, 2020·Journal of Medical Internet Research·Yu Heng KwanJulian Thumboo
Oct 10, 2020·Journal of Medical Internet Research·Yu Heng KwanJulian Thumboo

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