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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
John A. Dougherty, PhD1, Jeffrey D. Capizzi, ABD2, Geeta K. Sreedharan, MD, MPH2, Donna J. Cassidy, BSN3, and Ann Sola, MPH4. (1) Program Design and Evaluation Services, Multnomah County Health Department, Oregon, 426 SW Stark Street, 6th Floor, Portland, OR 97204, 503-988-3663 x22290, John.X.Dougherty@co.multnomah.or.us, (2) Program Design and Evaluation Services, Multnomah County Health Dept, 426 S.W. Stark St., 4th Floor, Portland, OR 97204, (3) HIV Health Services Center, Multnomah County Health Dept, 426 SW Stark St, 4th Floor, Portland, OR 97204, (4) Public Health Research, 2442 SE Sherman St., Portland, OR 97214
Abstract Text: Background: The degree to which antiretroviral (ART) medication-taking by clients matches the recommendations of prescribers (adherence) is the metric most often used by clinicians and researchers to estimate viral suppression and maintenance of health in persons living with HIV/AIDS. As part of a multi-site SPNS adherence support program evaluation, we have found that clinicians and researchers do not have a common procedure for defining or calculating ART adherence rates. Method: We describe the multiple ways used to define medication-taking behavior, the variety of time spans over which medication-taking is assessed, and the different procedures used to calculate adherence rates. Results: Depending on whether ART medication taking was defined on the basis of: 1) pills, single medications, or a regimen, 2) whether an observational period of 3-days, two-weeks, or one month was used, and 3) whether either of two procedures for calculating adherence rates were used, widely divergent adherence rates (differing by 5-25%) for the same set of data could be obtained. Conclusions: Current recommendations for adherence rates needed for adequate viral suppression by ART regimens may be widely misinterpreted and misapplied. We propose a taxonomy and set of minimum standards for reporting adherence-related data to establish a common basis for communicating and comparing clinical and research findings on ART medication adherence.
Learning Objectives:
Keywords: Treatment Adherence, Evaluation
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.