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Correlation between self-reported adherence to highly active antiretroviral therapy (HAART) and virologic outcome

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Abstract

The Patient Medication Adherence Questionnaire Version 1.0 (PMAQ-V1.0) is a patient-reported adherence instrument to assess medication-taking behaviors and identify barriers to adherence with antiretroviral therapy. To assess the correlation between adherence and virologic outcome, the PMAQ-V1.0 was administered to 194 antiretroviral-experienced adults with HIV infection enrolled in a 16-week evaluation of protease inhibitor-containing regimens featuring a lamivudine/ zidovudine combination tablet. At baseline, plasma HIV-1 RNA levels were less than 10,000 copies/mL and CD4+-cell counts were equal to or greater than 300 x 106/L; patients had been receiving a conventional regimen of lamivudine + zidovudine (separately) plus a protease inhibitor for at least 10 weeks immediately prior to the study. Forty-eight percent of patients who reported missing at least one dose of a nucleoside reverse-transcriptase inhibitor (NRTI) during the study had detectable plasma HIV-1 RNA, compared with 26% of patients who reported no missed doses (P = .002). Patients who missed at least one dose of an NRTI or protease inhibitor were 2.5 times more likely to have quantifiable HIV-1 RNA than those who reported no missed doses. Patients who reported fewer barriers and more motivators to adherence had better virologic outcomes (P = .001). Several dimensions of the PMAQ-V1.0 did not function as well as hypothesized. In this study, self-reported adherence derived from the PMAQ-V1.0 predicted virologic outcomes, but further refinement of the dimensions appears warranted.

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Authors and Affiliations

  1. Glaxo Wellcome Inc., Research Triangle Park, North Carolina

    Ralph A. DeMasi Ph.D. & Neil M. Graham M.D.

  2. GlaxoSmithKline Rm, US Medical Affairs Health Outcomes, 17.1239 Five Moore Drive, POBox 13398, 27709, Research Triangle Park, NC

    Jerry M. Tolson Ph.D., Sissi V. Pham Pharm.D., George A. Capuano M.S., Robin L. Fisher M.S.A., Mark S. Shaefer Pharm.D., Gary E. Pakes Pharm.D. & Gosford A. Sawyerr M.S.

  3. University of North Carolina, Chapel Hill, North Carolina

    Joseph J. Eron M.D.

Authors
  1. Ralph A. DeMasi Ph.D.
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  2. Neil M. Graham M.D.
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  3. Jerry M. Tolson Ph.D.
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  4. Sissi V. Pham Pharm.D.
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  5. George A. Capuano M.S.
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  6. Robin L. Fisher M.S.A.
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  7. Mark S. Shaefer Pharm.D.
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  8. Gary E. Pakes Pharm.D.
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When this manuscript was written, Drs. DeMasi and Graham were employed by Glaxo Wellcome Inc., Research Triangle Park, North Carolina, USA.

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DeMasi, R.A., Graham, N.M., Tolson, J.M. et al. Correlation between self-reported adherence to highly active antiretroviral therapy (HAART) and virologic outcome. Adv Therapy 18, 163–173 (2001). https://doi.org/10.1007/BF02850110

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