Paterson David L, Potoski Brian, Capitano Blair
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S103-6. doi: 10.1097/00126334-200212153-00003.
Measurement of adherence may be important in determining why patients fail antiretroviral therapy. Although patient self-report is by far the most frequently used means of assessing adherence, it overestimates adherence. However, patients who state they are nonadherent almost always are. The pill identification test is a recently described tool that may be useful in clinical practice. The best methods of adherence measurement are pill counts and electronic monitoring. Pill counts suffer from inability to record the time of consumption of therapy. Electronic monitoring enables timing of pill consumption and is the closest to a gold standard for measuring adherence. However, this is only the case if patients are carefully instructed in how to use the device, e.g., not to remove extra doses from their pill bottle. A composite adherence score has been developed that uses electronic monitoring, pill counts, and patient self-report. The authors believe that careful measurement of adherence is essential in the assessment of a patient failing to respond to antiretroviral therapy.
测量依从性对于确定患者抗逆转录病毒治疗失败的原因可能很重要。尽管患者自我报告是目前评估依从性最常用的方法，但它高估了依从性。然而，声称自己不依从的患者几乎总是如此。药丸识别测试是一种最近描述的工具，可能在临床实践中有用。测量依从性的最佳方法是药丸计数和电子监测。药丸计数的缺点是无法记录治疗的服用时间。电子监测能够记录药丸服用时间，是最接近测量依从性金标准的方法。然而，只有在患者得到如何使用该设备的仔细指导时，例如不要从药瓶中取出额外剂量，才会如此。已经开发了一种综合依从性评分，它使用电子监测、药丸计数和患者自我报告。作者认为，在评估对抗逆转录病毒治疗无反应的患者时，仔细测量依从性至关重要。
