Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome

Datos Bibliográficos

ID23347647
AutoresJohn Walsh (0000-0002-2510-8734, Chelsea and Westminster Hospital), John C Walsh, Sundhiya Mandalia (0000-0003-2546-498X, Chelsea and Westminster Hospital), Brian Gazzard (Chelsea and Westminster Hospital), Brian G Gazzard
Año2002
Volumen16
Número2
Páginas269-277
Fecha de publicación2002-01-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAIDS (JOURNAL)
Identificadores de la revistaISSN: 0269-9370 • E-ISSN: 1473-5571
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00002030-200201250-00017
PMID11807312
OpenAlexW2058117818
IdiomaEN
Citas recibidas86
Referencias citadas17

OBJECTIVES: Many questionnaires on adherence to antiretroviral therapy are in use, but the validity of patients' responses has not been tested. The Medication Adherence Self-Report Inventory (MASRI) has been developed and tested for its validity against objective measures and treatment outcome. DESIGN: Prospective study comparing questionnaire responses with MEMS TrackCap (MC, a medication event monitoring system), pill count (PC) and plasma HIV viraemia in a publicly funded specialist HIV clinic. PARTICIPANTS: Patients self-medicating antiretroviral therapy who were not cognitively impaired and were able to read and understand English. RESULTS: Mean adherence by MC of the 78 subjects was 92.9% (SE, 1.8%) and by PC 96.8% (SE, 1.4%). Agreement between MC and responses to items about doses missed 1, 2 or 3 days ago was low (kappa = 0.23 (P < 0.03), 0.44 (P < 0.001) and 0.28 (P < 0.01) respectively). This improved when these responses were summated (kappa = 0.46;P < 0.001) and was similar to that for recall of non-adherence over the preceding 2 weeks (kappa = 0.54; P < 0.001). Mean self-reported adherence by visual analogue scale (VAS) over the preceding month was 93.3% (SE, 1.2%). This was strongly associated with both MC (r = 0.63; P < 0.001) and PC (r = 0.75; P < 0.001). On multivariate analysis, the strongest association between a MASRI item and MC was for the VAS. Both the 2 week recall and VAS items were inversely associated with viral load (P = 0.01). There was no association between dose timing (measured MC or questionnaire) or 3 day self-report and viral load. CONCLUSIONS: The MASRI provides a means of measuring patient adherence that is valid when compared with objective measures.

Antiretroviral therapy · Cohen's kappa · Human immunodeficiency virus (HIV) · Kappa · Multivariate analysis · Physical therapy · Pill · Prospective cohort study · Recall · Viral load · Viremia · Visual analogue scale · HIV/AIDS Research and Interventions · Immunology · Internal Medicine · Medication Adherence and Compliance · Medicine · Mobile Health and mHealth Applications · Psychology