OBJECTIVE: The aim of the study was to determine how well self-reported adherence fares compared to therapeutic drug monitoring in monitoring HAART adherence. METHODS: We administered a validated self-reported adherence (SRA) questionnaire to 925 HIV patients on HAART in a large Malaysian hospital from 2010 to 11. We also performed Therapeutic Drug monitoring (TDM) by concurrently collecting and testing blood samples for Efavirenz, Nevirapine and Lamivudine using Liquid Chromatography/Mass Spectrometry. We compared the SRA against the TDM results. Sensitivity, specificity, positive (PPV) and negative predictive (NPV) and diagnostic accuracy values were computed for each drug. RESULTS: Self-reported adherence (SRA) over-estimates adherence by between 6 and 10 percentage points compared to therapeutic drug monitoring (TDM). SRA is highly sensitive with sensitivity exceeding 0.90 but is not very specific (0.56-0.63). PPV for SRA ranged between 0.76 (Lamivudine) and 0.84 (Efavirenz) while NPV ranged between 0.78 (Lamivudine) and 0.81 (Efavirenz). Overall diagnostic accuracy ranged between 0.76 (Lamivudine) and 0.84 (Nevirapine). CONCLUSION: Self-reported adherence is a surprisingly accurate instrument for measuring HAART adherence compared to TDM and can be reliably used in practice in resource-poor settings.
OBJECTIVE: The aim of the study was to determine how well self-reported adherence fares compared to therapeutic drug monitoring in monitoring HAART adherence. METHODS: We administered a validated self-reported adherence (SRA) questionnaire to 925 HIVpatients on HAART in a large Malaysian hospital from 2010 to 11. We also performed Therapeutic Drug monitoring (TDM) by concurrently collecting and testing blood samples for Efavirenz, Nevirapine and Lamivudine using Liquid Chromatography/Mass Spectrometry. We compared the SRA against the TDM results. Sensitivity, specificity, positive (PPV) and negative predictive (NPV) and diagnostic accuracy values were computed for each drug. RESULTS: Self-reported adherence (SRA) over-estimates adherence by between 6 and 10 percentage points compared to therapeutic drug monitoring (TDM). SRA is highly sensitive with sensitivity exceeding 0.90 but is not very specific (0.56-0.63). PPV for SRA ranged between 0.76 (Lamivudine) and 0.84 (Efavirenz) while NPV ranged between 0.78 (Lamivudine) and 0.81 (Efavirenz). Overall diagnostic accuracy ranged between 0.76 (Lamivudine) and 0.84 (Nevirapine). CONCLUSION: Self-reported adherence is a surprisingly accurate instrument for measuring HAART adherence compared to TDM and can be reliably used in practice in resource-poor settings.
Authors: Yuehan Zhang; Tracey E Wilson; Adebola Adedimeji; Daniel Merenstein; Joel Milam; Jennifer Cohen; Mardge Cohen; Elizabeth T Golub Journal: AIDS Behav Date: 2018-03
Authors: Aaron Farmer; Xun Wang; Anuradha Ganesan; Robert G Deiss; Brian K Agan; Thomas A O'Bryan; Kevin Akers; Jason F Okulicz Journal: AIDS Res Ther Date: 2016-03-22 Impact factor: 2.250
Authors: Awachana Jiamsakul; Nagalingeswaran Kumarasamy; Rossana Ditangco; Patrick C K Li; Praphan Phanuphak; Thira Sirisanthana; Somnuek Sungkanuparph; Pacharee Kantipong; Christopher K C Lee; Mahiran Mustafa; Tuti Merati; Adeeba Kamarulzaman; Thida Singtoroj; Matthew Law Journal: J Int AIDS Soc Date: 2014-05-16 Impact factor: 5.396