Source:http://linkedlifedata.com/resource/pubmed/id/11750214
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
2001-12-25
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| pubmed:abstractText |
We seek to develop a clinically useful measure of antiretroviral medication adherence. Because there is no gold standard for adherence, we will assess the clinical validity of patient- and provider-reported adherence by the strength of their expected associations with current viral load, depressive symptoms, alcohol and illicit drug use, and homelessness. The Veterans Aging Cohort 3 Site Study (VACS 3) is a multisite study of 881 patients at Cleveland, Houston, and Manhattan Veterans Affairs health care systems. Data was collected on adherence using patient report and provider assessment; depressive symptoms using the Center for Epidemiological Studies Depression (CESD) and provider assessment; alcohol use using the Alcohol Use Disorders Identification Test (AUDIT) and provider assessment; and homelessness using patient report only. Viral load was collected from electronic laboratory data. Although agreement between providers and patients about the patient's adherence was not better than chance (61%; weighted kappa =.07), both patient and provider-reported adherence were related to viral load (P <.001), current alcohol use (P <.01), current drug use (P <.01), and depressive symptoms (P <.001). Patient-reported adherence was also associated with homelessness (P <.05). In multivariate regression models, provider assessment of adherence demonstrated independent associations with viral load (P <.001), current alcohol use (P <.001), current drug use (P <.001), and depressive symptoms (P <.001) after adjustment for the patient's report of adherence (also significantly associated). The consistent and largely independent association between patient and provider reported adherence and a range of variables previously shown to be associated with adherence suggests that patient- and provider-reported adherence independently measure actual adherence. Future work will explore how patient- and provider-reported adherence might best be combined, and whether the measure may be further enhanced with pharmacy refill data.
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| pubmed:grant | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Dec
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| pubmed:issn |
0895-4356
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
54 Suppl 1
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
S91-8
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| pubmed:dateRevised |
2010-11-18
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| pubmed:meshHeading |
pubmed-meshheading:11750214-Antiretroviral Therapy, Highly Active,
pubmed-meshheading:11750214-Chronic Disease,
pubmed-meshheading:11750214-HIV Infections,
pubmed-meshheading:11750214-HIV-1,
pubmed-meshheading:11750214-Humans,
pubmed-meshheading:11750214-Longitudinal Studies,
pubmed-meshheading:11750214-Patient Compliance,
pubmed-meshheading:11750214-Physician's Practice Patterns,
pubmed-meshheading:11750214-Questionnaires,
pubmed-meshheading:11750214-Regression Analysis,
pubmed-meshheading:11750214-Self-Assessment,
pubmed-meshheading:11750214-Statistics, Nonparametric,
pubmed-meshheading:11750214-United States,
pubmed-meshheading:11750214-Veterans,
pubmed-meshheading:11750214-Viral Load
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| pubmed:year |
2001
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| pubmed:articleTitle |
Patient- and provider-reported adherence: toward a clinically useful approach to measuring antiretroviral adherence.
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| pubmed:affiliation |
Veterans Aging Cohort Study (VACS) Center, Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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| pubmed:publicationType |
Journal Article,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.,
Research Support, U.S. Gov't, Non-P.H.S.,
Research Support, Non-U.S. Gov't,
Multicenter Study
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