墨西哥一家国立医院针对艾滋病毒感染者的简化药物依从性问卷（SMAQ）：工具验证研究

Simplified Medication Adherence Questionnaire (SMAQ) for People Living With HIV in a National Hospital in Mexico: Instrument Validation Study.

作者信息

Del Moral Trinidad Luis Eduardo, González Hernández Luz Alicia, Andrade Villanueva Jaime Federico, Martínez-Ayala Pedro, Valle Rodríguez Adriana, Ruíz Herrera Vida Veronica, Vizcaíno Résendiz José Adán, Herrera Godina Melva Guadalupe, Dominguez-Lara Sergio

机构信息

Department of Public Health Sciences, University of Guadalajara, Guadalajara, Mexico.

HIV Unit, Hospital Civil de Guadalajara, Guadalajara, Mexico.

出版信息

Interact J Med Res. 2025 Jan 7;14:e59562. doi: 10.2196/59562.

DOI:10.2196/59562

PMID:39773472

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11751648/

Abstract

BACKGROUND

Adherence to antiretroviral therapy is a critical component in achieving viral suppression in people living with HIV in addition to increasing overall quality of life. Several indirect methods have been used to measure adherence including the Simplified Medication Adherence Questionnaire (SMAQ).

OBJECTIVE

The objective of this study is to evaluate the reliability and validity of the SMAQ in men living with HIV/AIDS attending a Mexican national hospital.

METHODS

A cross-sectional analytical design study was carried out in a Mexican National Hospital in Jalisco, including men aged >18 years with at least 3 months of antiretroviral treatment, excluding those with cognitive difficulties in answering the survey. A minimum sample size was calculated to detect the contribution of the variables within the model. The analysis included descriptive tests, confirmatory factor analysis, reliability and validity assessment, correlation between adherence and viral load, and association between viral load and adherence.

RESULTS

The final analysis included a total of 260 patients with a mean age of 43 (SD 12) years and an average of 8.97 (SD 6.33) years on antiretroviral treatment. The SMAQ showed sufficient structural validity (comparative fit index=1, root-mean-square error of approximation=0, 90% CI 0-0.085) with satisfactory factor loadings on most questions except item 2 (Do you always take your medication at the prescribed time?). The reliability of the scale is acceptable (Cronbach α=0.702, ω=0.718). Adherence correlated with viral load significantly but not with recent TCD4 lymphocyte levels. Patients classified as adherent were three times more likely to be undetectable than nonadherent patients (odds ratio 3.31, 95% CI 1.13-9.64, P=.04).

CONCLUSIONS

The SMAQ represents an adequate tool to assess adherence in men living with HIV in the Mexican context, this will contribute to this study and compression of adherence to establish future intervention programs.

摘要

背景

坚持抗逆转录病毒治疗是实现艾滋病毒感染者病毒抑制以及提高总体生活质量的关键组成部分。已经使用了几种间接方法来测量依从性，包括简化药物依从性问卷（SMAQ）。

目的

本研究的目的是评估SMAQ在一家墨西哥国立医院就诊的艾滋病毒/艾滋病男性患者中的可靠性和有效性。

方法

在哈利斯科州的一家墨西哥国立医院开展了一项横断面分析设计研究，纳入年龄大于18岁且接受抗逆转录病毒治疗至少3个月的男性，排除那些在回答调查问卷时有认知困难的患者。计算了最小样本量以检测模型中变量的贡献。分析包括描述性测试、验证性因素分析、可靠性和有效性评估、依从性与病毒载量之间的相关性以及病毒载量与依从性之间的关联。

结果

最终分析共纳入260例患者，平均年龄43（标准差12）岁，接受抗逆转录病毒治疗的平均时间为8.97（标准差6.33）年。SMAQ显示出足够的结构效度（比较拟合指数=1，近似均方根误差=0，90%可信区间0-0.085），除第2项问题（你是否总是在规定时间服药？）外，大多数问题的因子载荷令人满意。该量表的可靠性是可接受的（克朗巴哈α系数=0.702，ω系数=0.718）。依从性与病毒载量显著相关，但与近期CD4淋巴细胞水平无关。被归类为依从的患者病毒载量不可检测的可能性是非依从患者的三倍（优势比3.31，9设为上标5%可信区间1.13-9.64，P=0.04）。