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Long‐term utility of measuring adherence by self‐report compared with pharmacy record in a routine clinic setting
Author(s) -
Fairley CK,
Permana A,
Read TRH
Publication year - 2005
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2005.00322.x
Subject(s) - medicine , pharmacy , viral load , human immunodeficiency virus (hiv) , antiretroviral therapy , medical record , physical therapy , family medicine
Objectives To compare long‐term adherence to antiretroviral therapy in an HIV service, as measured by self‐report and by pharmacy records. To determine the level of adherence by each measure required to suppress viral load in a majority of patients. Methods The percentage of prescribed doses taken was calculated from (a) the number of missed doses in the previous 28 days reported by patients in a questionnaire at each clinic visit, and (b) pharmacy dispensing records. These were compared with each other and with HIV viral load data. Results Mean adherence was 96.2% by pharmacy record over 44 months and 98.6% by self‐report over 25 months. The two methods correlated with each other ( P< 0.001) and the proportion of patients with viral load <400 HIV‐1 RNA copies/mL increased with adherence as measured by self‐report ( P= 0.001) and pharmacy record ( P= 0.004). Fewer than 60% of patients always had viral loads <400 copies/mL if adherence fell below 95% (pharmacy record) or 97% (self‐report). Adherence was higher for once‐daily than for twice‐daily therapy (by pharmacy record: 97.2% vs. 96.0%; P <0.001). Adherence by both measures increased over time. Conclusions Self‐reported antiretroviral adherence correlates with pharmacy dispensing records and predicts suppression of viral load at levels ≥97%. It is practical to adopt this into routine HIV clinical care.