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巴西南部参与艾滋病毒阳性成年人药物治疗干预随机试验的患者临床随访不依从的预测因素。

Predictors of non-adherence to clinical follow-up among patients participating in a randomized trial of pharmaceutical care intervention in HIV-positive adults in Southern Brazil.

机构信息

Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, (UFPel), Campus Universitário, Capão do Leão, S/N, Caixa Postal 354, Pelotas, CEP 96010900, Brazil,

出版信息

AIDS Behav. 2014 Jan;18 Suppl 1:S85-8. doi: 10.1007/s10461-013-0591-0.

Abstract

Pharmaceutical care (PC) has been shown to improve adherence to therapeutic interventions as well as improve clinical outcomes. We assessed the predictors of non-adherence to clinical follow-up (i.e., not attending three scheduled routine clinical visits over a 1 year period) among patients who participated in a clinical trial of PC intervention on adherence to HIV antiretroviral therapy uptake (the PC-HIV trial). A total of 332 patients participated: median age was 39 years, 63 % were male, 76 % had CD4 count ≥200 cells/mm³, and 52 % had undetectable viral load. About half, 52.7 %, were non-adherent to clinical follow-up. Identified risk factors for non-adherence were male gender, age <40 years, and being in the trial's "control" group (adjusted odds ratio [AOR] 1.67, 95 % CI 1.05-2.66; AOR 2.21, 95 % CI 1.42-3.47; AOR 1.67, 95 % CI 1.07-2.61, respectively). Younger, male patients may benefit from interventions such as PC, which facilitates engagement in care.

摘要

药物治疗(PC)已被证明可以提高对治疗干预的依从性,并改善临床结果。我们评估了参与 PC 干预对 HIV 抗逆转录病毒治疗依从性(PC-HIV 试验)的患者在临床随访(即,1 年内未参加三次预定的常规临床就诊)方面的不依从预测因素。共有 332 名患者参与:中位年龄为 39 岁,63%为男性,76%的 CD4 计数≥200 个细胞/mm³,52%的病毒载量不可检测。约一半,52.7%的患者不遵守临床随访。不依从的风险因素包括男性、年龄<40 岁和处于试验的“对照组”(调整后的优势比 [AOR] 1.67,95%置信区间 [CI] 1.05-2.66;AOR 2.21,95%CI 1.42-3.47;AOR 1.67,95%CI 1.07-2.61)。年轻、男性患者可能受益于 PC 等干预措施,这有助于他们参与治疗。

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