i
Heterogeneity among studies in rates of decline of ART adherence over time: Results from the MACH14 study
-
Dec 15 2013
Source: J Acquir Immune Defic Syndr. 64(5):448-454. -
Alternative Title:J Acquir Immune Defic Syndr
-
Publisher's site:
-
Personal Author:
-
Corporate Authors:
-
Description:Objective
To use electronic drug monitoring to determine if adherence to HIV antiretroviral therapy changes over time, whether changes are linear, and how the declines vary by study.
Design
We conducted a longitudinal study of pooled data from 11 different studies of HIV infected adults using antiretroviral therapy. The main outcome was antiretroviral therapy adherence (percent of prescribed doses taken) measured by electronic drug monitoring. We modeled and compared changes in adherence over time using repeated measures linear mixed effects models and generalized additive mixed models. Indicator variables were used to examine the impact of individual studies, and the variation across studies was evaluated using study-specific parameter estimates calculated by using interaction terms of study and time.
Results
The mean age of the subjects was 41 years, 35% were female, most had high school education or less, and 46% were African-American. In generalized additive mixed models, adherence declined over time. The generalized additive mixed models further suggested that the decline was non-linear, and in both sets of models there was considerable study-to-study variability in how adherence changed over time.
Limitations
Findings may not be generalizable to non-US populations or to patients not in clinical studies.
Conclusions
Although overall antiretroviral therapy adherence declined with time, not all studies showed declines, and a number of patterns of change were seen. Studies that identify clinical and organizational factors associated with these different patterns are needed. Models of changes in adherence with time should take account of possible non-linear effects.
-
Subject:
-
Pubmed ID:24225904
-
Pubmed Central ID:PMC4212649
-
Document Type:
-
Funding:
-
Place as Subject:
-
Collection(s):
-
Main Document Checksum:
-
File Type:
[PDF-1.08 MB]
Details:
Supporting Files
More +
Email
CDC-INFO
