A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

Academic Article

Abstract

  • Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.
  • Published In

  • AIDS and Behavior  Journal
  • Keywords

  • Adherence, Depression, Hazardous alcohol use, Substance use, Viral load, Adult, Alcohol-Related Disorders, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Bayes Theorem, Comorbidity, Depressive Disorder, Female, HIV Infections, Humans, Linear Models, Logistic Models, Male, Medication Adherence, Middle Aged, Patient Health Questionnaire, Substance-Related Disorders, Surveys and Questionnaires, Time Factors, Viral Load
  • Digital Object Identifier (doi)

    Author List

  • Crane HM; Nance RM; Delaney JAC; Fredericksen RJ; Church A; Simoni JM; Harrington RD; Dhanireddy S; Safren SA; McCaul ME
  • Start Page

  • 470
  • End Page

  • 480
  • Volume

  • 21
  • Issue

  • 2