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Evaluating Adherence to Medication in Children and Adolescents with HIV
  1. Munziba Khan (mukhan{at}cnmc.org)
  1. Children's National Medical Center, United States
    1. Xiaoyan Song (xsong{at}cnmc.org)
    1. Children's National Medical Center, United States
      1. Keetra Williams (kkwillia{at}cnmc.org)
      1. Children's National Medical Center, United States
        1. Kimberly Bright (kbright{at}cnmc.org)
        1. Children's National Medical Center, United States
          1. Anne Sill (asill{at}cnmc.org)
          1. Children's National Medical Center, United States
            1. Natella Rakhmanina (nrakhman{at}cnmc.org)
            1. Children's National Medical Center, United States

              Abstract

              Objective: The study was aimed to evaluate the relationship between the pharmacy supply, self-reported treatment adherence and HIV viral load (VL) in HIV-infected children.

              Methods: A retrospective (52 weeks) cohort study was conducted through the review of the existing databases. The pharmacy supply was classified as “home delivery” when the medications were delivered home, and as “in pharmacy pick up”, when they were picked up at the pharmacy. The adherence was assessed through retrospective (3 days recall) self-report. Fisher Exact model, univariate and multivariate logistic regression analyses were used.

              Settings: The study collected the data on 140 HIV-infected children (<18 yrs old). The adherence, pharmacy supply information and HIV VL were obtained from clinical and research databases.

              Patients: The data from 127 HIV-infected children (60 boys/67 girls; mean age 9.9 yrs) were collected.

              Main outcome measures: The complete adherence (100%) was reported in only 24% of the patients. With 40% of the patients being rarely or never completely adherent, 64% of children achieved undetectable VL during the study period.

              Results: No association between pharmacy supply and self-reported adherence was found (p=0.605). Self-reported adherence (p=0.0328) and age (p=0.025) were the significant predictors of reaching undetectable VL. Adolescents (>13yrs) were significantly less likely to reach undetectable VL than children <13 yrs (OR=0.38; 95% CI: 0.16, 0.89).

              Conclusion: In our study, the pharmacy supply was not associated with self-reported adherence. Most importantly, adherence and age were significant predictors of reaching undetectable VL.

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