抗逆转录病毒药物依从性评估中的自我报告测量：与药物持有率和HIV病毒载量的比较
Self-Report Measures in the Assessment of Antiretroviral Medication Adherence: Comparison with Medication Possession Ratio and HIV Viral Load.
作者信息
Kabore Lassane, Muntner Paul, Chamot Eric, Zinski Anne, Burkholder Greer, Mugavero Michael J
机构信息
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
出版信息
J Int Assoc Provid AIDS Care. 2015 Mar-Apr;14(2):156-62. doi: 10.1177/2325957414557263. Epub 2014 Nov 23.
BACKGROUND
Adherence is a major determinant of the effectiveness of antiretroviral therapy (ART). We determined the association between self-reported adherence (SRA) and medication possession ratio (MPR), a pharmacy-based adherence measure, and their respective associations with viral load.
METHODS
Adherence to ART was assessed by MPR over 6 months and by self-report which included a question with a Likert-type scale response, a visual analogue scale (VAS), and an inquiry about the last time the patients skipped any prescribed medications.
RESULTS
Taking MPR as the "gold standard," all 3 SRA measures displayed high specificity but low sensitivity. The prevalence ratio (95% confidence interval) for viral load ≥50 copies/mL was 2.19 (1.07-4.50) for MPR <90%, 1.98 (1.04-3.78) for poor/fair/good versus excellent/very good ability to take antiretroviral drugs, 1.47 (0.79-2.75) for skipping medications within the past 2 weeks, and 2.51 (1.39-4.53) for VAS <95%.
CONCLUSION
These data suggest various SRA measures hold clinical value in screening for poor ART adherence.
背景
依从性是抗逆转录病毒疗法（ART）有效性的主要决定因素。我们确定了自我报告的依从性（SRA）与药物持有率（MPR，一种基于药房的依从性测量方法）之间的关联，以及它们各自与病毒载量的关联。
方法
通过MPR评估6个月内的ART依从性，并通过自我报告进行评估，自我报告包括一个具有李克特量表反应的问题、一个视觉模拟量表（VAS），以及询问患者最后一次漏服任何规定药物的时间。
结果
以MPR作为“金标准”，所有3种SRA测量方法均显示出高特异性但低敏感性。对于MPR<90%，病毒载量≥50拷贝/毫升的患病率比值（95%置信区间）为2.19（1.07 - 4.50）；对于服用抗逆转录病毒药物能力为差/一般/良好与优秀/非常好的情况，患病率比值为1.98（1.04 - 3.78）；对于在过去2周内漏服药物的情况，患病率比值为1.47（0.79 - 2.75）；对于VAS<95%的情况，患病率比值为2.51（1.39 - 4.53）。
结论
这些数据表明，各种SRA测量方法在筛查ART依从性差方面具有临床价值。
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