Nunn Andrew, Anywaine Zacchaeus, Seeley Janet, Munderi Paula, Levin Jonathan, Kasirye Ronnie, Kamali Anatoli, Abaasa Andrew, Grosskurth Heiner
MRC Clinical Trials Unit at University College London, London, UK.
MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
Contemp Clin Trials Commun. 2016 Aug 15;3:142-146. doi: 10.1016/j.conctc.2016.05.008.
COSTOP was a randomised controlled trial designed to assess the risks and benefits to HIV-infected participants stabilised on anti-retroviral treatment of stopping cotrimoxazole (CTX). In order to assess the extent to which patients may have had access to and used CTX other than that supplied as study drug it was decided to conduct an exit interview.
A structured interview was administered by interviewers who were not associated with the COSTOP trial team in order to make it easier for participants to respond truthfully to sensitive questions about adherence to the study protocol.
A total of 1993 participants were interviewed. Only 29 (1.7%) said they had taken their left over CTX; 101 (6.1%) had kept supplies at home. When asked about obtaining open label CTX during the trial 92 (4.7%) participants said they had done so, in contrast to only 12 who admitted doing so when asked at trial visits. The questions participants found most difficult to answer honestly at clinic visits were those concerning adherence to trial drugs (15.6% of participants) and whether they had slept under the insecticide treated mosquito nets (14.9%).
The exit interview demonstrated that there was some evidence of open label drug being taken by the participants. However, the results from the interview do not suggest that the trial results would have been seriously compromised. We would recommend the exit interview as a valuable way of assessing adherence to trial procedures.
“停止复方新诺明预防试验(COSTOP)”是一项随机对照试验,旨在评估接受抗逆转录病毒治疗病情稳定的HIV感染者停用复方新诺明(CTX)的风险和益处。为了评估患者除作为研究药物提供的CTX外,获取和使用CTX的程度,决定进行一次退出访谈。
由与COSTOP试验团队无关的访谈者进行结构化访谈,以便参与者更容易如实回答有关遵守研究方案的敏感问题。
共对1993名参与者进行了访谈。只有29人(1.7%)表示他们服用了剩余的CTX;101人(6.1%)家中有储备。当被问及在试验期间获取开放标签的CTX时,92名(4.7%)参与者表示他们这样做了,相比之下,在试验访视时被问及时只有12人承认这样做。参与者发现在门诊访视时最难如实回答的问题是关于遵守试验药物(15.6%的参与者)以及他们是否睡在经杀虫剂处理的蚊帐下(14.9%)。
退出访谈表明有一些证据显示参与者服用了开放标签药物。然而,访谈结果并不表明试验结果会受到严重影响。我们建议将退出访谈作为评估遵守试验程序情况的一种有价值的方式。