Ammassari A, Murri R, Pezzotti P, Trotta M P, Ravasio L, De Longis P, Lo Caputo S, Narciso P, Pauluzzi S, Carosi G, Nappa S, Piano P, Izzo C M, Lichtner M, Rezza G, Monforte A, Ippolito G, d'Arminio Moroni M, Wu A W, Antinori A
Clinica delle Malattie Infettive, Università Cattolica del S. Cuore, Roma, Italy.
J Acquir Immune Defic Syndr. 2001 Dec 15;28(5):445-9. doi: 10.1097/00042560-200112150-00006.
To identify variables predictive of nonadherence to highly active antiretroviral therapy (HAART) and to assess whether self-reported symptoms or medication side effects are related to adherence.
Cross-sectional multicenter study Adherence Italian Cohort Naive Antiretrovirals [AdICONA] within the Italian Cohort Naive Antiretrovirals (ICONA).
Participants receiving HAART completed a 16-item self-administered questionnaire to assess nonadherence in the last 3 days as well as the type and intensity of 24 common HIV- and HAART-related symptoms experienced during the last 4 weeks.
From May 1999 to March 2000, 358 persons were enrolled: 22% reported nonadherence and were less likely to have HIV RNA <500 copies/ml (odds ratio = 0.51; 95% confidence interval: 0.31-0.85). Frequency of moderate/severe symptoms or medication side effects in nonadherent participants ranged from 3.6% to 30%. On univariate analysis, nausea, anxiety, confusion, vision problems, anorexia, insomnia, taste perversion, and abnormal fat distribution were significantly associated with nonadherence. Nonadherent persons had a higher mean overall symptom score (12.3 +/- 9.2 versus 8.1 +/- 6.6; p <.001) and mean medication side effect score (2.9 +/- 2.7 versus 1.9 +/- 1.9; p <.001) when compared with adherent participants. In the multivariate analysis, nausea ( p =.003); anxiety ( p =.006); younger age ( p =.007); unemployment ( p <.001); not recalling name, color, and timing of drugs ( p =.009); running out of pills between visits ( p =.002); and being too busy ( p =.03) were independently associated with nonadherence in the last 3 days.
In addition to patient characteristics, medication-related variables, and reasons for nonadherence, patient-reported symptoms and medication side effects were significantly associated with adherence to HAART.
确定预测高效抗逆转录病毒疗法（HAART）治疗依从性不佳的变量，并评估自我报告的症状或药物副作用是否与依从性相关。
意大利初治抗逆转录病毒药物队列（ICONA）中的横断面多中心研究——意大利初治抗逆转录病毒药物队列依从性研究[AdICONA]。
接受HAART治疗的参与者完成一份16项的自我管理问卷，以评估过去3天的治疗依从性不佳情况，以及过去4周内经历的24种常见的与HIV和HAART相关症状的类型和强度。
从1999年5月至2000年3月，共招募了358人：22%的人报告有治疗依从性不佳情况，且其HIV RNA<500拷贝/毫升的可能性较小（比值比=0.51；95%置信区间：0.31-0.85）。依从性不佳的参与者中，中度/重度症状或药物副作用的发生率在3.6%至30%之间。单因素分析显示，恶心、焦虑、意识模糊、视力问题、厌食、失眠、味觉异常和脂肪分布异常与治疗依从性不佳显著相关。与依从性良好的参与者相比，依从性不佳的人总体症状平均得分更高（12.3±9.2对8.1±6.6；p<.001），药物副作用平均得分也更高（2.9±2.7对1.9±1.9；p<.001）。多因素分析显示，恶心（p=.003）、焦虑（p=.006）、年龄较小（p=.007）、失业（p<.001）、记不起药物名称、颜色和服用时间（p=.009）、就诊期间药物用完（p=.002）以及太忙（p=.03）与过去3天的治疗依从性不佳独立相关。
除了患者特征、与药物相关的变量以及治疗依从性不佳的原因外，患者报告的症状和药物副作用与HAART治疗依从性显著相关。
