Department of Global Health, University of Washington, Seattle, Washington.
Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
AIDS. 2021 Mar 1;35(3):463-475. doi: 10.1097/QAD.0000000000002777.
OBJECTIVE: Oral pre-exposure prophylaxis (PrEP) is an important HIV prevention method and studies have shown that young people ages 15-24 have difficulty adhering to daily PrEP. The field of PrEP delivery for young people is relatively nascent and lessons about potential PrEP adherence interventions could be learned from the larger evidence base of adherence interventions for other daily medications among youth. DESIGN: Systematic review of adherence support interventions for adolescents. METHODS: We searched PubMed, CINAHL, EMBASE, and PsycINFO through January 2020 for oral contraceptive pill (OCP), antiretroviral therapy (ART), asthma, and diabetes medication adherence interventions. We reviewed primary articles about OCP adherence interventions and reviewed systematic reviews for ART, asthma, and diabetes medication adherence interventions. Studies were retained if they included participants' ages 10-24 years; measured OCP, ART, asthma, or diabetes medication adherence; and were systematic reviews, randomized trials, or quasi-experimental studies. RESULTS: Fifteen OCP articles and 26 ART, diabetes, and asthma systematic reviews were included. Interventions that improved medication adherence for OCPs, ART, asthma, and diabetes treatment included reminder text messages, computer-based and phone-based support, and enhanced counseling. Multi-month prescriptions and same-day pill starts also were found to improve OCP adherence and continuation. Adolescent-friendly clinics and peer-based counseling significantly improved ART adherence, and telemedicine interventions improved diabetes medication adherence. CONCLUSION: Interventions that improve medication adherence among youth include enhanced counseling, extended pill supply, adolescent-friendly services, and text message reminders. PrEP programs could incorporate and evaluate such interventions for their impact on PrEP adherence and continuation among at-risk adolescents.
目的:口服暴露前预防(PrEP)是一种重要的 HIV 预防方法,研究表明,15-24 岁的年轻人难以坚持每天服用 PrEP。年轻人的 PrEP 提供领域相对较新,可以从针对年轻人其他日常药物的更大依从性干预证据基础中吸取关于潜在 PrEP 依从性干预的经验。
设计:对青少年依从性支持干预措施进行系统评价。
方法:我们通过 2020 年 1 月在 PubMed、CINAHL、EMBASE 和 PsycINFO 上搜索了关于口服避孕药(OCP)、抗逆转录病毒疗法(ART)、哮喘和糖尿病药物依从性干预的文献。我们审查了关于 OCP 依从性干预的原始文章,并审查了关于 ART、哮喘和糖尿病药物依从性干预的系统评价。如果研究包括参与者年龄在 10-24 岁;测量 OCP、ART、哮喘或糖尿病药物的依从性;且为系统评价、随机试验或准实验研究,则保留研究。
结果:纳入了 15 篇关于 OCP 的文章和 26 篇关于 ART、糖尿病和哮喘的系统评价。改善 OCP、ART、哮喘和糖尿病治疗药物依从性的干预措施包括提醒短信、基于计算机和基于电话的支持以及强化咨询。多月份处方和当天开始服用药丸也被发现可以提高 OCP 的依从性和持续使用。青少年友好型诊所和基于同伴的咨询显著提高了 ART 的依从性,远程医疗干预措施提高了糖尿病药物的依从性。
结论:改善青少年药物依从性的干预措施包括强化咨询、延长药物供应、青少年友好型服务和短信提醒。PrEP 项目可以考虑并评估这些干预措施对高危青少年 PrEP 依从性和持续使用的影响。
Cochrane Database Syst Rev. 2012-3-14
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