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Titolo:
Barriers to use of electronic adherence monitoring in an HIV clinic
Autore:
Wendel, CS; Mohler, MJ; Kroesen, K; Ampel, NM; Gifford, AL; Coons, SJ;
Indirizzi:
So Arizona Vet Affairs Hlth Care Syst, Hlth Serv Res Ctr 0 151, Tucson, AZ85723 USA So Arizona Vet Affairs Hlth Care Syst Tucson AZ USA 85723 on, AZ85723 USA Univ Arizona, Program Epidemiol, Tucson, AZ 85724 USA Univ Arizona TucsonAZ USA 85724 Program Epidemiol, Tucson, AZ 85724 USA Univ Arizona, Coll Med, Tucson, AZ 85721 USA Univ Arizona Tucson AZ USA 85721 Arizona, Coll Med, Tucson, AZ 85721 USA So Arizona Vet Affairs Hlth Care Syst, HIV Clin, Tucson, AZ 85721 USA So Arizona Vet Affairs Hlth Care Syst Tucson AZ USA 85721 n, AZ 85721 USA Vet Affairs San Diego Healthcare Syst, Hlth Serv Res & Dev Program, San Diego, CA 92103 USA Vet Affairs San Diego Healthcare Syst San Diego CA USA 92103 CA 92103 USA Univ Calif San Diego, Sch Med, La Jolla, CA 92093 USA Univ Calif San Diego La Jolla CA USA 92093 ch Med, La Jolla, CA 92093 USA Univ Arizona, Coll Pharm, Div Social & Adm Sci, Tucson, AZ 85721 USA Univ Arizona Tucson AZ USA 85721 v Social & Adm Sci, Tucson, AZ 85721 USA Univ Arizona, Coll Pharm, Div HIV Policy & Outcomes Res, Tucson, AZ 85721 USA Univ Arizona Tucson AZ USA 85721 icy & Outcomes Res, Tucson, AZ 85721 USA
Titolo Testata:
ANNALS OF PHARMACOTHERAPY
fascicolo: 9, volume: 35, anno: 2001,
pagine: 1010 - 1015
SICI:
1060-0280(200109)35:9<1010:BTUOEA>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROTEASE INHIBITORS; THERAPY; TRIAL;
Keywords:
adherence; antiretroviral therapies; compliance; HIV infections;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Wendel, CS So Arizona Vet Affairs Hlth Care Syst, Hlth Serv Res Ctr 0 151,3601 S 6thAve, Tucson, AZ 85723 USA So Arizona Vet Affairs Hlth Care Syst 3601 S 6th Ave Tucson AZ USA 85723
Citazione:
C.S. Wendel et al., "Barriers to use of electronic adherence monitoring in an HIV clinic", ANN PHARMAC, 35(9), 2001, pp. 1010-1015

Abstract

OBJECTIVE: To evaluate barriers to Medication Event Monitoring System (MEMS) measurement of adherence to combination antiretroviral therapy in an HIVclinic. DESIGN: Descriptive, cross-sectional study measured MEMS adherence to one antiretroviral for one month. SETTING: HIV clinic in a Veterans Affairs Medical Center. PARTICIPANTS: Sixty-four men on a stable antiretroviral treatment regimen. MAIN OUTCOME MEASURES: Decanting (removing >1 dose at a time) before and during monitoring over a 30-day observation period was used to determine thequalitative impact of MEMS on adherence. The adherence index was the proportion of prescribed doses not missed. RESULTS: Subjects were primarily white (73%) with mean CD4+ count 408 cells/mm(3), log viral load 1.81 copies/mL, and duration of antiretroviral therapy 5.5 years. Twenty-seven (42%) had some decanting routine established prior to monitoring; 12 (440%) of these patients used daily decanters and 15 (56%) used weekly pillboxes. Of those who decanted prior to the study, 10 (37%) did not stop decanting during monitoring, 14 (52%) stopped decanting only the Gapped medication, and three (11%) stopped decanting all antiretrovirals. Other adherence strategies did not accommodate MEMS. Eight (13%) subjects said MEMS made adherence more difficult, six (9%) said MEMS was a reminder to adhere, and two (3%) mentioned both. Two subjects attributed skipped doses or time changes to the MEMS cap. The majority who refused to participate used pillboxes. CONCLUSIONS: Personal adherence strategies incompatible with MEMS are common in persons on complex treatment regimens. Although MEMS data on decanters underestimate adherence, excluding decanters erodes applicability of descriptive measures. MEMS use may have affected adherence behavior. Measures in conjunction with MEMS should include self-reported adherence and decanting assessment.

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Documento generato il 29/03/20 alle ore 01:18:49