Côté José K, Godin Gaston
University Laval, Quebec, Canada.
Int J STD AIDS. 2005 May;16(5):335-43. doi: 10.1258/0956462053888934.
The aim of this paper is to perform a critical review of the effectiveness of interventions for the purpose of enhancing adherence to antiretroviral therapy. The overall evaluation indicates that research is in its early stages. Although pilot studies provide support for the feasibility of their protocols, and preliminary results also suggest their capacity to improve adherence, only three major trials have reported significant improvement in adherence. The issues that will have to be addressed by future studies include: (a) the need for a theoretical and empirical understanding of the phenomena; (b) adoption of a format that fits the attributes of the population; (c) the use of multiple strategies involving key providers; (d) a concise and precise schedule governing the frequency and intensity of the intervention; (e) a careful selection of direct outcome; and (f) appropriate time measurement. In sum, greater efforts to design and evaluate interventions are needed to lead to an increase in adherence and improvement in treatment effectiveness.
本文旨在对旨在提高抗逆转录病毒疗法依从性的干预措施的有效性进行批判性综述。总体评估表明，相关研究尚处于早期阶段。尽管试点研究为其方案的可行性提供了支持，初步结果也表明它们有提高依从性的能力，但只有三项主要试验报告了依从性有显著改善。未来研究需要解决的问题包括：（a）需要从理论和实证角度理解这些现象；（b）采用适合人群特征的形式；（c）使用涉及关键提供者的多种策略；（d）制定一个简洁精确的时间表来规定干预的频率和强度；（e）仔细选择直接结果；（f）进行适当的时间测量。总之，需要做出更大努力来设计和评估干预措施，以提高依从性并改善治疗效果。
