Adherence to antiretroviral therapy - appropriate use of self reporting in clinical practice

Pratt, Robert, Loveday, Heather, Pellowe, C.M., Robinson, Nicola, Franks, Peter J., Hankins, Matthew and Loveday, Clive (2001) Adherence to antiretroviral therapy - appropriate use of self reporting in clinical practice. HIV Clinical Trials, 2 (2). pp. 146-159. ISSN 1528-4336

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Abstract

PURPOSE:
This study investigated the factors that may affect adherence to antiretroviral therapy in people with HIV infection and compared the use of three self-report tools to determine client adherence.
METHOD:
A descriptive, cross-sectional study of 260 HIV-infected clients attending nine HIV outpatient centers in England was conducted using researcher-administered instruments. Self-reports of adherence were assessed using the Morisky Medication Adherence Scale (MMAS), Reported Adherence to Medication Scale (RAM), and the Patient Adjustment to Medication Scale (PAM).
RESULTS:
Univariate analysis of clients' self-reports indicated a number of associations with adherence. Significant associations with less adherent behavior identified by two or more self-report tools were the reported use of recreational drugs, p = .001; living alone, p = .041; feeling depressed, p = .02; being influenced by the media, p = .037; and lack of a close confidant, p = .037. Greater adherence was associated with clients reporting a positive mental attitude to HIV infection, p = .038. Principal component analysis (PCA) of each self-report tool identified two well-recognized constructs: intentional nonadherence and nonintentional nonadherence. In addition, a third construct of following instructions was identified from PAM, a scale developed by the authors. Subsequent regression analysis failed to confirm the associations with adherence suggested by the univariate analysis.
CONCLUSION:
This study suggests that the design and use of self-report tools to identify client's adherence to complex antiretroviral regimens may need to measure individual constructs of adherence to accurately assess adherence behavior.

Item Type: Article
Uncontrolled Keywords: HIV infection; Antiretroviral therapy; Self-report tools; Morisky Medication Adherence Scale (MMAS); Reported Adherence to Medication Scale (RAM); Patient Adjustment to Medication Scale (PAM).
Subjects: Medicine and health > Clinical medicine
Depositing User: Rod Pow
Date Deposited: 06 Jul 2012 09:18
Last Modified: 06 Oct 2017 15:50
URI: http://repository.uwl.ac.uk/id/eprint/96

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