Watt Melissa H, Maman Suzanne, Golin Carol E, Earp Jo Anne, Eng Eugenia, Bangdiwala Shrikant I, Jacobson Mark
Duke Global Health Institute, Duke University, Durham, NC, USA.
AIDS Care. 2010 Mar;22(3):381-9. doi: 10.1080/09540120903193708.
This study aimed to determine the level of antiretroviral adherence and factors associated with adherence among patients receiving free antiretroviral therapy (ART) at one clinic in Tanzania. Adult patients were recruited into the cross-sectional study and completed a survey that included self-reported adherence over four days and over one month. Less than 95% adherence on either measure was considered "poor." Factors associated with adherence in unadjusted analyses (alpha = 0.10) were included in a logistic regression model. A total of 340 patients participated in the study, and 5.9% (20/340) reported poor adherence. The final model found poor adherence associated with: being young (odds ratio (OR) = 4.03) or old (OR = 6.68); having lower perceived quality of patient-provider interaction (OR = 2.75); and ever missing a clinic appointment (OR = 3.13). Results highlight good adherence, but suggest the importance of addressing: (1) age-specific challenges of adherence through counseling and support; (2) client-focused care and quality of patient-provider interaction; and (3) clinic appointment reminder systems.
本研究旨在确定坦桑尼亚一家诊所接受免费抗逆转录病毒治疗(ART)的患者的抗逆转录病毒治疗依从性水平以及与依从性相关的因素。成年患者被纳入这项横断面研究,并完成了一项调查,其中包括自我报告的四天和一个月的依从情况。任何一项测量中依从性低于95%被视为“差”。在未校正分析(α = 0.10)中与依从性相关的因素被纳入逻辑回归模型。共有340名患者参与了该研究,5.9%(20/340)报告依从性差。最终模型发现依从性差与以下因素相关:年轻(比值比(OR)= 4.03)或年老(OR = 6.68);患者与医护人员互动的感知质量较低(OR = 2.75);以及曾错过门诊预约(OR = 3.13)。结果凸显了良好的依从性,但也表明应对以下方面的重要性:(1)通过咨询和支持应对特定年龄的依从性挑战;(2)以患者为中心的护理以及患者与医护人员互动的质量;(3)门诊预约提醒系统。