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Keynote webinar | Spotlight on medication adherence

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AIDS and Behavior
Published in: AIDS and Behavior 4/2015

01-04-2015 | Original Paper

Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children

Authors: Rachel C. Vreeman, Winstone M. Nyandiko, Hai Liu, Wanzhu Tu, Michael L. Scanlon, James E. Slaven, Samuel O. Ayaya, Thomas S. Inui

Published in: AIDS and Behavior | Issue 4/2015

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Abstract

For HIV-infected children, adherence to antiretroviral therapy (ART) is often assessed by caregiver report but there are few data on their validity. We conducted prospective evaluations with 191 children ages 0–14 years and their caregivers over 6 months in western Kenya to identify questionnaire items that best predicted adherence to ART. Medication Event Monitoring Systems® (MEMS, MWV/AARDEX Ltd., Switzerland) electronic dose monitors were used as external criterion for adherence. We employed a novel variable selection tool using the LASSO technique with logistic regression to identify items best correlated with dichotomized MEMS adherence (≥90 or <90 % doses taken). Nine of 48 adherence items were identified as the best predictors of adherence, including missed or late doses in the past 7 days, problems giving the child medicines, and caregiver-level factors like not being present at medication taking. These items could be included in adherence assessment tools for pediatric patients.
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Literature
1.
World Health Organization. Global HIV/AIDS response: epidemic update and health sector progress towards universal access—progress report 2011. Geneva: World Health Organization; 2011.
2.
Doerholt K, Duong T, Tookey P, et al. Outcomes for human immunodeficiency virus-1-infected infants in the United kingdom and Republic of Ireland in the era of effective antiretroviral therapy. Pediatr Infect Dis J. 2006;25(5):420–6.CrossRefPubMed
3.
Gibb DM, Duong T, Tookey PA, et al. Decline in mortality, AIDS, and hospital admissions in perinatally HIV-1 infected children in the United Kingdom and Ireland. BMJ (Clin Res ed). 2003;327(7422):1019.CrossRef
4.
Gibb DM, Goodall RL, Giacomet V, McGee L, Compagnucci A, Lyall H. Adherence to prescribed antiretroviral therapy in human immunodeficiency virus-infected children in the PENTA 5 trial. Pediatr Infect Dis J. 2003;22(1):56–62.CrossRefPubMed
5.
Hogg RS, Heath KV, Yip B, et al. Improved survival among HIV-infected individuals following initiation of antiretroviral therapy. JAMA. 1998;279(6):450–4.CrossRefPubMed
6.
Needham DM, Hogg RS, Yip B, O’Shaughnessy M, Schechter MT, Montaner JS. The impact of antiretroviral therapy on AIDS survival observed in a province-wide drug treatment programme. Int J STD AIDS. 1998;9(6):370–2.PubMed
7.
Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2007;4(2):65–72.CrossRefPubMed
8.
Gavin PJ, Yogev R. The role of protease inhibitor therapy in children with HIV infection. Paediatr Drugs. 2002;4(9):581–607.CrossRefPubMed
9.
Mullen J, Leech S, O’Shea S, et al. Antiretroviral drug resistance among HIV-1 infected children failing treatment. J Med Virol. 2002;68(3):299–304.CrossRefPubMed
10.
San-Andres FJ, Rubio R, Castilla J, et al. Incidence of acquired immunodeficiency syndrome-associated opportunistic diseases and the effect of treatment on a cohort of 1115 patients infected with human immunodeficiency virus, 1989–1997. Clin Infect Dis. 2003;36(9):1177–85.CrossRefPubMed
11.
Tam LW, Chui CK, Brumme CJ, et al. The relationship between resistance and adherence in drug-naive individuals initiating HAART is specific to individual drug classes. J Acquir Immune Defic Syndr. 2008;49(3):266–71.CrossRefPubMedCentralPubMed
12.
Chesney MA. The elusive gold standard. Future perspectives for HIV adherence assessment and intervention. J Acquir Immune Defic Syndr. 2006;43(Suppl 1):S149–55.CrossRefPubMed
13.
Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10(3):227–45.CrossRefPubMedCentralPubMed
14.
Vreeman RC, Nyandiko WM, Blaschke TF. Adherence to antiretroviral therapy for adults and children in resource-limited settings. Rev Antivir Ther. 2009;2(Suppl):S6–13.
15.
Simoni JM, Montgomery A, Martin E, New M, Demas PA, Rana S. Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management. Pediatrics. 2007;119(6):e1371–83.CrossRefPubMed
16.
Allison SM, Koenig LJ, Marhefka SL, et al. Assessing medication adherence of perinatally HIV-infected children using caregiver interviews. J Assoc Nurses AIDS Care. 2010;21(6):478–88.CrossRefPubMedCentralPubMed
17.
Farley J, Hines S, Musk A, Ferrus S, Tepper V. Assessment of adherence to antiviral therapy in HIV-infected children using the Medication Event Monitoring System, pharmacy refill, provider assessment, caregiver self-report, and appointment keeping. J Acquir Immune Defic Syndr. 2003;33(2):211–8.CrossRefPubMed
18.
Van Dyke RB, Lee S, Johnson GM, et al. Reported adherence as a determinant of response to highly active antiretroviral therapy in children who have human immunodeficiency virus infection. Pediatrics. 2002;109(4):e61.CrossRefPubMed
19.
Haberer JE, Cook A, Walker AS, et al. Excellent adherence to antiretrovirals in HIV+Zambian children is compromised by disrupted routine, HIV nondisclosure, and paradoxical income effects. PLoS ONE. 2011;6(4):e18505.CrossRefPubMedCentralPubMed
20.
Davies MA, Boulle A, Fakir T, Nuttall J, Eley B. Adherence to antiretroviral therapy in young children in Cape Town, South Africa, measured by medication return and caregiver self-report: a prospective cohort study. BMC Pediatr. 2008;8:34.CrossRefPubMedCentralPubMed
21.
Vreeman RC, Wiehe SE, Pearce EC, Nyandiko WM. A systematic review of pediatric adherence to antiretroviral therapy in low- and middle-income countries. Pediatr Infect Dis J. 2008;27(8):686–91.CrossRefPubMed
22.
Arnsten JH, Demas PA, Farzadegan H, et al. Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: comparison of self-report and electronic monitoring. Clin Infect Dis. 2001;33(8):1417–23.CrossRefPubMedCentralPubMed
23.
Deschamps AE, De Geest S, Vandamme AM, Bobbaers H, Peetermans WE, Van Wijngaerden E. Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards. AIDS Patient Care STDS. 2008;22(9):735–43.CrossRefPubMed
24.
Thompson MA, Mugavero MJ, Amico KR, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Ann Intern Med. 2012;156(11):817–33.CrossRefPubMedCentralPubMed
25.
Muller AD, Jaspan HB, Myer L, et al. Standard measures are inadequate to monitor pediatric adherence in a resource-limited setting. AIDS Behav. 2011;15(2):422–31.CrossRefPubMedCentralPubMed
26.
Boyd MA, Cooper DA. Second-line combination antiretroviral therapy in resource-limited settings: facing the challenges through clinical research. AIDS. 2007;21(Suppl 4):S55–63.CrossRefPubMed
27.
Vreeman RC, Nyandiko WM, Ayaya SO, Walumbe EG, Marrero DG, Inui TS. Factors sustaining pediatric adherence to antiretroviral therapy in western Kenya. Qual Health Res. 2009;19(12):1716–29.CrossRefPubMed
28.
Vreeman RC, Nyandiko WM, Ayaya SO, Walumbe EG, Inui TS. Cognitive interviewing for cross-cultural adaptation of pediatric antiretroviral therapy adherence measurement items. Int J Behav Med. 2014;21:186–96.CrossRefPubMed
29.
Einterz RM, Kimaiyo S, Mengech HN, et al. Responding to the HIV pandemic: the power of an academic medical partnership. Acad Med. 2007;82(8):812–8.CrossRefPubMed
30.
Inui TS, Nyandiko WM, Kimaiyo SN, et al. AMPATH: living proof that no one has to die from HIV. J Gen Int Med. 2007;22(12):1745–50.CrossRef
31.
Tibshirani R. Regression shrinkage and selection via the LASSO. J R Stat Soc Ser B. 1996;58(1):267–88.
32.
Meier L, Van De Geer S, Buhlmann P. The group LASSO for logistic regression. J R Stat Soc Ser B. 2008;70(1):53–71.CrossRef
33.
Bangsberg D, Hecht FM, Charlebois ED, Chesney M, Moss A. Comparing objective measures of adherence to HIV antiretroviral therapy: electronic medication monitors and unannounced pill counts. AIDS Behav. 2001;5(3):275–81.CrossRef
34.
Haberer JE, Kiwanuka J, Nansera D, Ragland K, Mellins C, Bangsberg DR. Multiple measures reveal antiretroviral adherence successes and challenges in HIV-infected Ugandan children. PLoS ONE. 2012;7(5):e36737.CrossRefPubMedCentralPubMed
35.
Bangsberg DR, Moss AR, Deeks SG. Paradoxes of adherence and drug resistance to HIV antiretroviral therapy. J Antimicrob Chemother. 2004;53(5):696–9.CrossRefPubMed
36.
Sethi AK, Celentano DD, Gange SJ, Moore RD, Gallant JE. Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis. 2003;37(8):1112–8.CrossRefPubMed
37.
Bangsberg DR. Less than 95 % adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.CrossRefPubMed
38.
Wilson IB, Bangsberg DR, Shen J, et al. Heterogeneity among studies in rates of decline of antiretroviral therapy adherence over time: results from the multisite adherence collaboration on HIV 14 study. J Acquir Immune Defic Syndr. 2013;64(5):448–54.CrossRefPubMedCentralPubMed
39.
WHO. WHO Global Database on Child Growth and Malnutrition. Geneva: World Health Organization; 1997.
40.
Marhefka SL, Farley JJ, Rodrigue JR, Sandrik LL, Sleasman JW, Tepper VJ. Clinical assessment of medication adherence among HIV-infected children: examination of the Treatment Interview Protocol (TIP). AIDS Care. 2004;16(3):323–38.CrossRefPubMed
41.
Katko E, Johnson GM, Fowler SL, Turner RB. Assessment of adherence with medications in human immunodeficiency virus-infected children. Pediatr Infect Dis J. 2001;20(12):1174–6.CrossRefPubMed
42.
Scanlon ML, Vreeman RC. Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings. HIV/AIDS Res Palliat Care. 2013;5:1–17.
43.
Berg KM, Arnsten JH. Practical and conceptual challenges in measuring antiretroviral adherence. J Acquir Immune Defic Syndr. 2006;43(Suppl 1):S79–87.CrossRefPubMedCentralPubMed
44.
Bova CA, Fennie KP, Knafl GJ, Dieckhaus KD, Watrous E, Williams AB. Use of electronic monitoring devices to measure antiretroviral adherence: practical considerations. AIDS Behav. 2005;9(1):103–10.CrossRefPubMed
45.
Muller AD, Bode S, Myer L, Roux P, von Steinbuchel N. Electronic measurement of adherence to pediatric antiretroviral therapy in South Africa. Pediatr Infect Dis J. 2008;27(3):257–62.CrossRefPubMed
46.
Wendel CS, Mohler MJ, Kroesen K, Ampel NM, Gifford AL, Coons SJ. Barriers to use of electronic adherence monitoring in an HIV clinic. Ann Pharmacother. 2001;35(9):1010–5.CrossRefPubMed
Metadata
Title
Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children
Authors
Rachel C. Vreeman
Winstone M. Nyandiko
Hai Liu
Wanzhu Tu
Michael L. Scanlon
James E. Slaven
Samuel O. Ayaya
Thomas S. Inui
Publication date
01-04-2015
Publisher
Springer US
Published in
AIDS and Behavior / Issue 4/2015
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-015-0998-x

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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