在常规门诊环境中，通过自我报告与药房记录来测量依从性的长期效用比较。

Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting.

作者信息

Fairley C K, Permana A, Read T R H

机构信息

Melbourne Sexual Health Centre, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

HIV Med. 2005 Sep;6(5):366-9. doi: 10.1111/j.1468-1293.2005.00322.x.

DOI:10.1111/j.1468-1293.2005.00322.x

PMID:16156886

Abstract

OBJECTIVES

To compare long-term adherence to antiretroviral therapy in an HIV service, as measured by self-report and by pharmacy records. To determine the level of adherence by each measure required to suppress viral load in a majority of patients.

METHODS

The percentage of prescribed doses taken was calculated from (a) the number of missed doses in the previous 28 days reported by patients in a questionnaire at each clinic visit, and (b) pharmacy dispensing records. These were compared with each other and with HIV viral load data.

RESULTS

Mean adherence was 96.2% by pharmacy record over 44 months and 98.6% by self-report over 25 months. The two methods correlated with each other (P<0.001) and the proportion of patients with viral load <400 HIV-1 RNA copies/mL increased with adherence as measured by self-report (P=0.001) and pharmacy record (P=0.004). Fewer than 60% of patients always had viral loads <400 copies/mL if adherence fell below 95% (pharmacy record) or 97% (self-report). Adherence was higher for once-daily than for twice-daily therapy (by pharmacy record: 97.2% vs. 96.0%; P<0.001). Adherence by both measures increased over time.

CONCLUSIONS

Self-reported antiretroviral adherence correlates with pharmacy dispensing records and predicts suppression of viral load at levels >or=97%. It is practical to adopt this into routine HIV clinical care.

摘要

目的

比较通过自我报告和药房记录衡量的艾滋病病毒（HIV）服务中抗逆转录病毒疗法的长期依从性。确定在大多数患者中抑制病毒载量所需的每种测量方法的依从性水平。

方法

从以下两方面计算规定剂量的服用百分比：（a）患者在每次诊所就诊时通过问卷报告的前28天漏服剂量数；（b）药房配药记录。将这些数据相互比较，并与HIV病毒载量数据进行比较。

结果

在44个月期间，药房记录的平均依从性为96.2%，在25个月期间自我报告的平均依从性为98.6%。两种方法相互关联（P<0.001），病毒载量<400 HIV-1 RNA拷贝/mL的患者比例随着自我报告（P=0.001）和药房记录（P=0.004）测量的依从性增加而增加。如果依从性低于95%（药房记录）或97%（自我报告），则始终病毒载量<400拷贝/mL的患者不到60%。每日一次治疗的依从性高于每日两次治疗（药房记录：97.2%对96.0%；P<0.001）。两种测量方法的依从性均随时间增加。