Weiss L, French T, Finkelstein R, Waters M, Mukherjee R, Agins B
Office of Special Populations, New York Academy of Medicine, NY 10029, USA.
AIDS Care. 2003 Oct;15(5):673-9. doi: 10.1080/09540120310001595159.
Near perfect adherence is considered essential for patients on HAART, yet adherence to medical recommendations is rarely so high. Supportive services and reminder tools may help individuals to become adherent, yet it is difficult to determine who may need such interventions. In this study, based on data from the NYSDOH/AIDS Institute Treatment Adherence Demonstration Program, we look at the association between HIV-related knowledge and adherence, hypothesizing that a better understanding of HIV and its treatment is associated with better adherence. In analyses based on 997 participants, knowledge, as measured by five true/false questions, was significantly associated with self-reported adherence. In multivariate analysis, compared to persons with four or five items answered correctly, persons with fewer correct answers were more likely to report missed doses (OR = 1.72 for 2-3 correct, p < 0.01; OR = 2.92 for 0-1 correct, p < 0.05). Our data suggest that providers should include questions focused on knowledge of HIV in their assessments of medication readiness and need for adherence support. Similarly, providers should be diligent with respect to patient education, ensuring that each patient has the information needed to support reasoned decision making and adequate adherence.
对于接受高效抗逆转录病毒治疗（HAART）的患者而言，近乎完美的依从性被认为至关重要，然而对医疗建议的依从性却很少能达到如此高的程度。支持性服务和提醒工具或许能帮助个体实现依从，但很难确定谁可能需要这类干预措施。在本研究中，基于纽约州卫生部/艾滋病研究所治疗依从性示范项目的数据，我们考察了与HIV相关的知识和依从性之间的关联，假设对HIV及其治疗有更深入的了解与更好的依从性相关。在对997名参与者进行的分析中，通过五个是非题衡量的知识水平与自我报告的依从性显著相关。在多变量分析中，与答对四题或五题的人相比，答对题目较少的人更有可能报告有漏服剂量的情况（答对2 - 3题的OR = 1.72，p < 0.01；答对0 - 1题的OR = 2.92，p < 0.05）。我们的数据表明，医疗服务提供者在评估患者用药准备情况和对依从性支持的需求时，应纳入侧重于HIV知识的问题。同样，医疗服务提供者应认真做好患者教育工作，确保每位患者都掌握支持合理决策和充分依从所需的信息。
