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AIDS and Behavior
Published in: AIDS and Behavior 2/2017

01-02-2017 | Original Paper

A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

Authors: H. M. Crane, R. M. Nance, J. A. C. Delaney, R. J. Fredericksen, A. Church, J. M. Simoni, R. D. Harrington, S. Dhanireddy, S. A. Safren, M. E. McCaul, W. B. Lober, P. K. Crane, I. B. Wilson, M. J. Mugavero, M. M. Kitahata

Published in: AIDS and Behavior | Issue 2/2017

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Abstract

Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.
Literature
1.
Wood E, Hogg RS, Yip B, Harrigan PR, O’Shaughnessy MV, Montaner JS. Effect of medication adherence on survival of HIV-infected adults who start highly active antiretroviral therapy when the CD4 + cell count is 0.200 to 0.350 × 109 cells/L. Ann Intern Med. 2003;139(10):810–6.CrossRefPubMed
2.
Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.CrossRefPubMed
3.
Bangsberg DR, Hecht FM, Charlebois ED, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000;14(4):357–66.CrossRefPubMed
4.
Bangsberg DR, Perry S, Charlebois ED, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181–3.CrossRefPubMed
5.
Wood E, Hogg RS, Yip B, Harrigan PR, O’Shaughnessy MV, Montaner JS. Is there a baseline CD4 cell count that precludes a survival response to modern antiretroviral therapy? AIDS. 2003;17(5):711–20.CrossRefPubMed
6.
Donnell D, Baeten JM, Kiarie J, et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375(9731):2092–8.CrossRefPubMedPubMedCentral
7.
Gross R, Bilker WB, Friedman HM, Coyne JC, Strom BL. Provider inaccuracy in assessing adherence and outcomes with newly initiated antiretroviral therapy. AIDS. 2002;16(13):1835–7.CrossRefPubMed
8.
Bangsberg DR, Hecht FM, Clague H, et al. Provider assessment of adherence to HIV antiretroviral therapy. J Acquir Immune Defic Syndr. 2001;26(5):435–42.CrossRefPubMed
9.
Bangsberg DR. Monitoring adherence to HIV antiretroviral therapy in routine clinical practice: the past, the present, and the future. AIDS Behav. 2006;10(3):249–51.CrossRefPubMed
10.
11.
Knobel H, Alonso J, Casado JL, et al. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS. 2002;16(4):605–13.CrossRefPubMed
12.
Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G. The rational clinical examination. Is this patient taking the treatment as prescribed? JAMA. 1993;269(21):2779–81.CrossRefPubMed
13.
Kimmerling M, Wagner G, Ghosh-Dastidar B. Factors associated with accurate self-reported adherence to HIV antiretrovirals. Int J STD AIDS. 2003;14(4):281–4.CrossRefPubMed
14.
Wagner G. Utility of self-reported antiretroviral adherence: comment on Simoni et al. (2006). AIDS Behav. 2006;10(3):247–8.CrossRefPubMed
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.CrossRefPubMedPubMedCentral
16.
Liu H, Golin CE, Miller LG, et al. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134(10):968–77.CrossRefPubMed
17.
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.CrossRefPubMedPubMedCentral
18.
Lu M, Safren SA, Skolnik PR, et al. Optimal recall period and response task for self-reported HIV medication adherence. AIDS Behav. 2008;12(1):86–94.CrossRefPubMed
19.
Wilson IB, Carter AE, Berg KM. Improving the self-report of HIV antiretroviral medication adherence: is the glass half full or half empty? Curr HIV/AIDS Rep. 2009;6(4):177–86.CrossRefPubMedPubMedCentral
20.
Walsh JC, Mandalia S, Gazzard BG. Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. AIDS. 2002;16(2):269–77.CrossRefPubMed
21.
Oyugi JH, Byakika-Tusiime J, Charlebois ED, et al. Multiple validated measures of adherence indicate high levels of adherence to generic HIV antiretroviral therapy in a resource-limited setting. J Acquir Immune Defic Syndr. 2004;36(5):1100–2.CrossRefPubMed
22.
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.CrossRefPubMedPubMedCentral
23.
Nieuwkerk PT, Oort FJ. Self-reported adherence to antiretroviral therapy for HIV-1 infection and virologic treatment response: a meta-analysis. J Acquir Immune Defic Syndr. 2005;38(4):445–8.CrossRefPubMed
24.
Feldman BJ, Fredericksen RJ, Crane PK, et al. Evaluation of the single-item self-rating adherence scale for use in routine clinical care of people living with HIV. AIDS Behav. 2012;17(1):307–18.CrossRef
25.
Mannheimer S, Thackeray L, Huppler Hullsiek K, et al. A randomized comparison of two instruments for measuring self-reported antiretroviral adherence. AIDS Care. 2008;20(2):161–9.CrossRefPubMed
26.
Simoni JM, Huh D, Wang Y, et al. The validity of self-reported medication adherence as an outcome in clinical trials of adherence-promotion interventions: findings from the MACH14 study. AIDS Behav. 2014;18(12):2285–90.CrossRefPubMedPubMedCentral
27.
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.CrossRefPubMedPubMedCentral
28.
Stirratt MJ, Dunbar-Jacob J, Crane HM, et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Transl Behav Med. 2015;5(4):470–82.CrossRefPubMedPubMedCentral
29.
Amico KR, Zuniga JM, Wilson IB, Gross R, Young B. Provider guidance for linking patients to antiretroviral therapy adherence interventions: recommendations from an IAPAC advisory committee on adherence monitoring and support. J Int Assoc Provid AIDS Care. 2013;12(2):79–83.CrossRefPubMed
30.
Pearson CR, Simoni JM, Hoff P, Kurth AE, Martin DP. Assessing antiretroviral adherence via electronic drug monitoring and self-report: an examination of key methodological issues. AIDS Behav. 2007;11(2):161–73.CrossRefPubMedPubMedCentral
31.
Fredericksen RJ, Crane PK, Tufano J, et al. Integrating a web-based patient assessment into primary care for HIV-infected adults. J AIDS HIV Res. 2012;4(2):47–55.CrossRefPubMedPubMedCentral
32.
Crane HM, Fredericksen R, Feldman B, et al. The effect of pre-visit reports to providers of patient reported outcomes (PROs) in routine clinical care. Paper presented at: 6th International Conference on HIV Treatment and Prevention Adherence. Miami, FL; 2011.
33.
Crane HM, Lober W, Webster E, et al. Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients. Curr HIV Res. 2007;5(1):109–18.CrossRefPubMed
34.
Crane HM, Grunfeld C, Harrington RD, Uldall KK, Ciechanowski PS, Kitahata MM. Lipoatrophy among HIV-infected patients is associated with higher levels of depression than lipohypertrophy. HIV Med. 2008;9(9):780–6.CrossRefPubMedPubMedCentral
35.
Lawrence ST, Willig JH, Crane HM, et al. Routine, self-administered, touch-screen, computer-based suicidal ideation assessment linked to automated response team notification in an HIV primary care setting. Clin Infect Dis. 2010;50(8):1165–73.CrossRefPubMedPubMedCentral
36.
Amico KR, Fisher WA, Cornman DH, et al. Visual analog scale of ART adherence: association with 3-day self-report and adherence barriers. J Acquir Immune Defic Syndr. 2006;42(4):455–9.CrossRefPubMed
37.
Chesney MA, Ickovics JR, Chambers DB, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000;12(3):255–66.CrossRefPubMed
38.
Newcombe DA, Humeniuk RE, Ali R. Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site. Drug Alcohol Rev. 2005;24(3):217–26.CrossRefPubMed
39.
WHO Assist Working Group. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002;97(9):1183–94.CrossRef
40.
Tucker JS, Burnam MA, Sherbourne CD, Kung FY, Gifford AL. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am J Med. 2003;114(7):573–80.CrossRefPubMed
41.
Ingersoll K. The impact of psychiatric symptoms, drug use, and medication regimen on non-adherence to HIV treatment. AIDS Care. 2004;16(2):199–211.CrossRefPubMed
42.
Bradley KA, Bush KR, Epler AJ, et al. Two brief alcohol-screening tests from the Alcohol Use Disorders Identification Test (AUDIT): validation in a female veterans affairs patient population. Arch Intern Med. 2003;163(7):821–9.CrossRefPubMed
43.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMed
44.
Gual A, Segura L, Contel M, Heather N, Colom J. AUDIT-3 and AUDIT-4: effectiveness of two short forms of the alcohol use disorders identification test. Alcohol Alcoholism. 2002;37(6):591–6.CrossRefPubMed
45.
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282(18):1737–44.CrossRefPubMed
46.
47.
Raftery A, Madigan D, Hoeting J. Bayesian model averaging for linear regression models. J Am Stat Assoc. 1997;92(437):179–91.CrossRef
48.
Raftery A. Bayesian model selection in social research. Sociol Methodol. 1995;25:111–63.CrossRef
49.
Hoeting J, Madigan D, Raftery A, Volinsky C. Bayesian model averaging: a tutorial. Stat Sci. 1999;14(4):382–417.CrossRef
50.
Volinsky C, Madigan D, Raftery A, Kronmal R. Bayesian model averaging in proportional hazard models: assessing the risk of a stroke. Appl Stat. 1997;46(3):443–8.
51.
Viallefont V, Raftery AE, Richardson S. Variable selection and Bayesian model averaging in case-control studies. Stat Med. 2001;20(21):3215–30.CrossRefPubMed
52.
Nieuwkerk PT, Sprangers MA, Burger DM, et al. Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study. Arch Intern Med. 2001;161(16):1962–8.CrossRefPubMed
53.
54.
Wilson IB, Fowler FJ Jr, Cosenza CA, et al. Cognitive and field testing of a new set of medication adherence self-report items for HIV care. AIDS Behav. 2013. doi:10.​1007/​s10461-013-0610-1.
Metadata
Title
A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?
Authors
H. M. Crane
R. M. Nance
J. A. C. Delaney
R. J. Fredericksen
A. Church
J. M. Simoni
R. D. Harrington
S. Dhanireddy
S. A. Safren
M. E. McCaul
W. B. Lober
P. K. Crane
I. B. Wilson
M. J. Mugavero
M. M. Kitahata
Publication date
01-02-2017
Publisher
Springer US
Published in
AIDS and Behavior / Issue 2/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-016-1566-8

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