Department of Health Studies, University of South Africa, Unisa. 0003, South Africa.
Int J Nurs Stud. 2011 Nov;48(11):1323-9. doi: 10.1016/j.ijnurstu.2011.04.006. Epub 2011 May 13.
Providing anti-retroviral therapy (ART) to patients free of charge enhances their wellbeing, reduces the number of opportunistic infections and enables them to live productive lives, but only if these drugs are taken regularly every day for the rest of their lives. Patients' ART adherence levels are difficult and expensive to estimate. If simple available measures, such as pharmacy refill records, could be correlated with laboratory test results for improved CD4 counts (indicating immunological recovery) and decreased viral loads (VLs--indicating virological recovery), these could be used as preliminary measures of adherence.
The objective was to determine whether the combination of pharmacy refill records and pill counts (including counts for all medications in the HAART regimen) could predict immunological and virologic responses through increased CD4 cell counts and suppressed VL.
Correlations were compiled for patients' pharmacy refill records, pill counts, CD4 cell counts, VL counts and self-reported ART adherence at one clinic in Gaborone, Botswana. There was a weak positive, relationship between ART adherence, CD4 cell counts and VL. Pharmacy refills and pill counts adherence measurement methodologies scored high on sensitivity and positive predictive values.
Pharmacy refill records and pill counts are useful indicators of patients' ART adherence levels, but should be supplemented with CD4 and VL counts at regular intervals.
为患者免费提供抗逆转录病毒疗法（ART）可以提高他们的生活质量，减少机会性感染的发生，并使他们能够过上富有成效的生活，但前提是这些药物必须在余生中每天都按时服用。评估患者的 ART 服药依从性水平既困难又昂贵。如果能够将药房 refill 记录等简单的可用措施与实验室检测结果（CD4 计数增加，表明免疫恢复；病毒载量降低，表明病毒学恢复）相关联，那么这些措施就可以作为服药依从性的初步评估手段。
本研究旨在确定药房 refill 记录和药片计数（包括 HAART 方案中所有药物的计数）的组合是否可以通过增加 CD4 细胞计数和抑制病毒载量来预测免疫和病毒学反应。
在博茨瓦纳哈博罗内的一家诊所，我们对患者的药房 refill 记录、药片计数、CD4 细胞计数、病毒载量和自我报告的 ART 服药依从性进行了相关性分析。ART 服药依从性、CD4 细胞计数和病毒载量之间呈弱正相关。药房 refill 和药片计数的依从性测量方法在灵敏度和阳性预测值方面得分较高。
药房 refill 记录和药片计数是患者 ART 服药依从性水平的有用指标，但应定期结合 CD4 和 VL 计数进行补充。
