Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands.
J Acquir Immune Defic Syndr. 2010 Dec 15;55(5):635-40. doi: 10.1097/QAI.0b013e3181fba6ab.
Refill data are increasingly used to assess adherence in HIV-infected patients on combination antiretroviral therapy. However, it is not clear how feasible this method is when multiple pharmacies are involved. Also, the effects of inclusion of leftover medication from previous refills and prescribed treatment time on adherence calculations are unknown. We addressed these questions in the present study.
Adult HIV-1-infected patients were recruited at the outpatient clinic of the Academic Medical Centre in Amsterdam and asked for their pharmacies' names. Refill data were obtained from pharmacies. Percentages of patients misclassified as nonadherent when disregarding leftover medication and prescribed treatment interruptions were calculated. Finally, we investigated whether an average adherence calculation of all drugs or a calculation based on one drug in the regimen best predicted virological failure (plasma HIV-1 RNA >40 copies/mL).
Two hundred one patients were included. Collecting data from multiple pharmacies (132) was found to be feasible. Forty-three percent of patients were misclassified as nonadherent when disregarding leftover medication and 2 percent when disregarding prescribed treatment time. There was no difference in predicting virological failure by different calculations of adherence.
These findings suggest that studies using pharmacy refill data should include leftover medication.
越来越多的研究使用药物续配数据来评估接受抗逆转录病毒治疗的 HIV 感染者的服药依从性。然而，当涉及多家药店时，这种方法的可行性尚不清楚。此外，纳入前次续配剩余药物和规定治疗时间对服药依从性计算的影响也不清楚。本研究旨在探讨这些问题。
阿姆斯特丹学术医学中心的门诊招募了成年 HIV-1 感染者，并询问他们的药店名称。从药店获取续配数据。计算不考虑剩余药物和规定治疗中断时将多少患者错误分类为不依从的百分比。最后，我们研究了是否所有药物的平均依从性计算或方案中一种药物的计算最能预测病毒学失败（血浆 HIV-1 RNA >40 拷贝/mL）。
共纳入 201 例患者。发现从多家药店（132 家）收集数据是可行的。不考虑剩余药物时，43%的患者被错误分类为不依从，不考虑规定治疗时间时，2%的患者被错误分类为不依从。不同的依从性计算方法对预测病毒学失败无差异。
这些发现表明，使用药店续配数据的研究应纳入剩余药物。
