Kelly J Daniel, Hubenthal Erica A, Lurton Gregoire, Empson Susannah F, Barrie M Bailor, Kargbo Brima, Wagner Glenn J, Giordano Thomas P
Baylor College of Medicine, Houston, USA.
Int J STD AIDS. 2013 Dec;24(12):931-7. doi: 10.1177/0956462413487327. Epub 2013 Jul 15.
In resource-poor settings, studies validating multiple self-report measures of adherence are limited and do not include data from West Africa. We prospectively assessed the associations between multiple self-report measures of adherence in 58 patients receiving antiretroviral therapy. Self-report measures included a 30-day visual analog scale, 30-day qualitative single-item measure, Adult AIDS Clinical Trial Group 4-day recall, and 3-level categorical 7-day qualitative measure. Unannounced pill count was the objective measure. Spearman's rho correlation coefficients, Bland-Altman plots, and receiver operator curve analyses were performed. Median and mean adherence by pill count were 81.8% and 78.6%, respectively. All self-report measures had either intermediate or high correlation with the pill count, and the 7-day measure had the highest level of correlation with pill count (r = 0.72). All self-report measures demonstrated good agreement when mean pill count adherence was greater than 90%. All but the 7-day measure posed challenges to patient understanding and administration of the measure. In this sample of participants that displayed largely suboptimal adherence, the 7-day measure was preferable, but all self-report measures demonstrated relatively good agreement with the objective criterion pill count measure and are adequate for clinical use in settings such as Sierra Leone.
在资源匮乏地区，验证多种自我报告依从性测量方法的研究有限，且未纳入来自西非的数据。我们前瞻性评估了58例接受抗逆转录病毒治疗患者的多种自我报告依从性测量方法之间的关联。自我报告测量方法包括30天视觉模拟量表、30天定性单项测量、成人艾滋病临床试验组4天回忆法以及3级分类7天定性测量。不预先通知的药丸计数是客观测量方法。进行了斯皮尔曼等级相关系数、布兰德-奥特曼图分析以及受试者工作特征曲线分析。通过药丸计数得出的依从性中位数和均值分别为81.8%和78.6%。所有自我报告测量方法与药丸计数均具有中等或高度相关性，且7天测量方法与药丸计数的相关性最高（r = 0.72）。当平均药丸计数依从性大于90%时，所有自我报告测量方法均显示出良好的一致性。除7天测量方法外，所有其他方法在患者对测量方法的理解和实施方面都存在挑战。在这个依从性大多不理想的参与者样本中，7天测量方法更可取，但所有自我报告测量方法与客观标准药丸计数测量方法均显示出相对良好的一致性，适用于塞拉利昂等地区的临床使用。
