Ryan G W, Wagner G J
RAND Corporation, Santa Monica, CA 90407, USA.
AIDS Care. 2003 Dec;15(6):795-806. doi: 10.1080/09540120310001618649.
This exploratory study examines the contextual factors that lead to episodic nonadherence to highly active antiretroviral therapy. Unlike global adherence that refers to the overall probability that a participant will take his or her medication over a given time period, episodic adherence refers to whether an individual took a particular dose (e.g., Saturday morning, 17 September). Semi-structured, qualitative interviews were conducted with a convenience sample of 27 consecutive participants enrolled in ongoing adherence trials who had missed at least one dose of antiretroviral medication during the past 2 days. A qualitative analysis revealed that routinization of pill regimens and factors associated with the participant's ability to maintain these routines (e.g., time of day of scheduled dose; location of participant at time of dose) play an important role in successful adherence. In addition, psychosocial factors such as psychological distress, substance abuse, and active and unpredictable social lives may act as barriers to adherence. Implications for adherence interventions are discussed.
这项探索性研究考察了导致间歇性不坚持高效抗逆转录病毒治疗的背景因素。与全球依从性（指参与者在给定时间段内服用药物的总体概率）不同，间歇性依从性指的是个体是否服用了特定剂量的药物（例如，9月17日星期六上午）。对27名连续参与正在进行的依从性试验的参与者进行了半结构化定性访谈，这些参与者在过去两天内至少漏服了一剂抗逆转录病毒药物。定性分析表明，服药方案的常规化以及与参与者维持这些常规的能力相关的因素（例如，预定剂量的时间；服药时参与者的位置）在成功依从方面起着重要作用。此外，心理社会因素，如心理困扰、药物滥用以及活跃且不可预测的社交生活，可能会成为依从性的障碍。文中还讨论了对依从性干预措施的启示。
