| Adherence to Antiretroviral Therapy in HIV-Positive Adolescents in Uganda Assessed by Multiple Methods: A Prospective Cohort Study. | |
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MedLine Citation:
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PMID: 22765225 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: The effectiveness of traditional adherence measurements used in adolescent populations is difficult to assess. Antiretroviral (ARV) adherence research among adolescents living with HIV in resource-constrained countries is particularly challenging and little evidence is available. Objectives: The primary objective of this study was to determine the feasibility of a large-scale, long-term study using electronic adherence monitoring in Uganda. The secondary objective was to compare accuracy of pill count (PC) and self-report (SR) adherence with electronic medication vials (eCAPs™). Methods: Adolescents receiving ARV therapy at the Joint Clinical Research Centre in Kampala, Uganda, were recruited. ARVs were dispensed in eCAPs™ for 1 year. Person-pill-days (PPDs) [1 day where adherence was measured for one medication in one patient] were calculated and a weighted paired t-test was used to compare the levels of adherence among subjects for three different adherence measurement methods. Results: Fifteen patients were included: 40% were female, mean age was 14 years, mean baseline CD4+ cell count was 244 cells/μL, and average treatment duration was 9 months at study entry. Overall, 4721 PPDs were observed. Some eCAPs™ required replacement during the study resulting in some data loss. Consent rate was high (94%) but was slow due to age limit cut-points. Overall adherence for SR was 99%, PC was 97% and eCAP™ was 88% (p < 0.05 for all comparisons). 93%, 67% and 23% of patients had an adherence of greater than 95% as measured by SR, PC and eCAP™ methods, respectively. Conclusions: A large-scale adherence study in Uganda would be feasible using a more robust electronic monitoring system. Adherence measurements produced by PCs and self-reporting methods appear to overestimate adherence measured electronically. |
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Authors:
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Matthew O Wiens; Stuart Macleod; Victor Musiime; Mark Ssenyonga; Ruth Kizza; Sabrina Bakeera-Kitaka; Richard Odoi-Adome; Francis Ssali |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-6 |
Journal Detail:
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Title: Paediatric drugs Volume: - ISSN: 1179-2019 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883685 Medline TA: Paediatr Drugs Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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