Correlation between self-reported adherence to highly active antiretroviral therapy (HAART) and virologic outcome

• Published in: Advances in therapy Vol. 18; no. 4; pp. 163 - 173
• Main Authors: DeMasi, Ralph A., Graham, Neil M., Tolson, Jerry M., Pham, Sissi V., Capuano, George A., Fisher, Robin L., Shaefer, Mark S., Pakes, Gary E., Sawyerr, Gosford A., Eron, Joseph J.
• Format: Journal Article
• Language: English
• Published: Edison, NJ Health Communications 01.07.2001
• Subjects: Adolescent; Adult; AIDS Serodiagnosis; Anti-HIV Agents - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Drug Administration Schedule; Drug Combinations; Female; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV-1 - isolation & purification; Human immunodeficiency virus 1; Humans; Lamivudine - administration & dosage; Logistic Models; Male; Medical sciences; Middle Aged; Patient Compliance - statistics & numerical data; Patient Participation; Pharmacology. Drug treatments; Prospective Studies; RNA, Viral - analysis; Surveys and Questionnaires; Treatment Refusal - statistics & numerical data; Viral Load; Zidovudine - administration & dosage; Questionnaire; RNA-directed DNA polymerase; HIV-1 virus; Self evaluation; Drug compliance; Reverse transcriptase inhibitor; Antiviral; Viral load; Pyrimidine nucleoside; Human; Drug combination; Enzyme; Transferases; Retroviridae; Enzyme inhibitor; Lamivudine; Lentivirus; Infection; Virus; Nucleotidyltransferases; Chemotherapy; Treatment; Dideoxynucleoside; Viral disease; Human immunodeficiency virus; Zidovudine; Protease inhibitor
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/BF02850110

The Patient Medication Adherence Questionnaire Version 1.0 (PMAQ-V1.0) is a patient-reported adherence instrument to assess medication-taking behaviors and identify barriers to adherence with antiretroviral therapy. To assess the correlation between adherence and virologic outcome, the PMAQ-V1.0 was administered to 194 antiretroviral-experienced adults with HIV infection enrolled in a 16-week evaluation of protease inhibitor-containing regimens featuring a lamivudine/zidovudine combination tablet. At baseline, plasma HIV-1 RNA levels were less than 10,000 copies/mL and CD4(+)-cell counts were equal to or greater than 300 x 10(6)/L; patients had been receiving a conventional regimen of lamivudine + zidovudine (separately) plus a protease inhibitor for at least 10 weeks immediately prior to the study. Forty-eight percent of patients who reported missing at least one dose of a nucleoside reverse-transcriptase inhibitor (NRTI) during the study had detectable plasma HIV-1 RNA, compared with 26% of patients who reported no missed doses (P = .002). Patients who missed at least one dose of an NRTI or protease inhibitor were 2.5 times more likely to have quantifiable HIV-1 RNA than those who reported no missed doses. Patients who reported fewer barriers and more motivators to adherence had better virologic outcomes (P = .001). Several dimensions of the PMAQ-V1.0 did not function as well as hypothesized. In this study, self-reported adherence derived from the PMAQ-V1.0 predicted virologic outcomes, but further refinement of the dimensions appears warranted.