University Federico II, Department of Pediatrics, Via S. Pansini, 5, 80131 Naples, Italy.
Expert Opin Pharmacother. 2009 Dec;10(17):2773-8. doi: 10.1517/14656560903376178.
In a previous multicentre study including 129 HIV-infected children, non-adherence to antiretroviral therapy was detected in 16% of patients and was mainly related to psychosocial rather than clinical or demographic features. The aim of this study was to explore the evolving pattern of adherence and its determinants in the same population of children.
An observational, cross-sectional multicentre study was done through a structured interview to the caregivers of HIV-infected children. Adherence was quantitatively evaluated through a 4-day recall adherence instrument.
One hundred and twelve children were included. Nineteen (17%) omitted more than 5% of doses in the preceding 4 days and were considered non-adherent. Of these, 10 had been found non-adherent and nine adherent in the previous study. In parallel, nine of the originally non-adherent children had become adherent. Adherence rates were higher in children receiving therapy from foster parents than in children receiving therapy from biological parents. Dose number significantly correlated with adherence.
Adherence to antiretroviral therapy is a dynamic phenomenon that changes with time. The evolving pattern shows a fairly constant distribution of adherence because a similar number of patients gain and lose adherence. Psychosocial rather than clinical features are major determinants of adherence.
在之前一项包含 129 名 HIV 感染儿童的多中心研究中，16%的患者被发现未遵医嘱服用抗逆转录病毒药物，这主要与心理社会因素而非临床或人口统计学特征有关。本研究旨在探索同一批儿童中依从性的变化模式及其决定因素。
通过对 HIV 感染儿童的照顾者进行结构化访谈，进行了一项观察性、横断面多中心研究。通过为期 4 天的回顾性依从性工具对依从性进行定量评估。
共纳入 112 名儿童。19 名（17%）儿童在过去 4 天中漏服超过 5%的剂量，被认为是不依从的。其中，10 名儿童在之前的研究中被发现不依从，9 名儿童被发现依从。同时，最初不依从的 9 名儿童中有 9 名变得依从。从寄养父母处接受治疗的儿童的依从率高于从亲生父母处接受治疗的儿童。剂量数与依从性显著相关。
抗逆转录病毒治疗的依从性是一个动态现象，随时间而变化。依从性的变化模式显示出相对稳定的依从性分布，因为有相同数量的患者获得和失去依从性。心理社会因素而非临床特征是依从性的主要决定因素。
