Ascertaining baseline levels of antiretroviral therapy adherence in Uganda

a multimethod approach

Setor Kunutsor, Morgan Evans, Janine Thoulass, John Walley, Elly Katabira, James N Newell, Simon Muchuro, Hudson Balidawa, Elizabeth Namagala, Eric Ikoona

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Many antiretroviral treatment (ART) adherence measurement methods have been employed by different studies, but no single method has been found to be appropriate for all settings. This study aimed to determine baseline levels of adherence using 2 measures of adherence.

Methods: Levels of adherence in 967 patients continuing to receive ART in 4 health facilities were assessed over a 28-week period using a clinic-based pill count method and a patient self-report questionnaire. Factors associated with adherence were also determined.

Results: Mean adherence (95% confidence interval) was 97.3% (96.8% to 97.9%) and 98.4% (97.9% to 98.8%) for the clinic-based pill count and patient self-report methods, respectively. Proportion of clients achieving optimal adherence (≥95%) was 89.9% by pill count and 94.2% by self-report. The 2 adherence measures were closely correlated with each other (r = 0.87, P = 0.000). Adherence increased with age (P = 0.014) with patients aged 40 years and below being less likely to achieve optimal adherence [odds ratio = 0.55; 95% confidence interval (0.34 to 0.89)].

Conclusions: There is a very high level of optimal adherence among patients still on treatment. The combined use of these 2 replicable and reliable methods of measuring adherence is vital to ART programs in resource-constrained settings.
Original languageEnglish
Pages (from-to)221-224
Number of pages4
JournalJournal of acquired immune deficiency syndromes : JAIDS.
Volume55
Issue number2
DOIs
Publication statusPublished - 1 Oct 2010

Fingerprint

Uganda
Self Report
Therapeutics
Confidence Intervals
Health Facilities
Patient Compliance
Odds Ratio

Keywords

  • adolescent
  • adult
  • age factors
  • anti-HIV agents
  • confidence intervals
  • female
  • HIV infections
  • humans
  • linear models
  • male
  • medication adherence
  • middle aged
  • multivariate analysis
  • odds ratio
  • prospective studies
  • questionnaires
  • Uganda
  • young adult

Cite this

Ascertaining baseline levels of antiretroviral therapy adherence in Uganda : a multimethod approach. / Kunutsor, Setor; Evans, Morgan; Thoulass, Janine; Walley, John; Katabira, Elly; Newell, James N; Muchuro, Simon; Balidawa, Hudson; Namagala, Elizabeth; Ikoona, Eric.

In: Journal of acquired immune deficiency syndromes : JAIDS. , Vol. 55, No. 2, 01.10.2010, p. 221-224.

Research output: Contribution to journalArticle

Kunutsor, S, Evans, M, Thoulass, J, Walley, J, Katabira, E, Newell, JN, Muchuro, S, Balidawa, H, Namagala, E & Ikoona, E 2010, 'Ascertaining baseline levels of antiretroviral therapy adherence in Uganda: a multimethod approach', Journal of acquired immune deficiency syndromes : JAIDS. , vol. 55, no. 2, pp. 221-224. https://doi.org/10.1097/QAI.0b013e3181e255ec
Kunutsor, Setor ; Evans, Morgan ; Thoulass, Janine ; Walley, John ; Katabira, Elly ; Newell, James N ; Muchuro, Simon ; Balidawa, Hudson ; Namagala, Elizabeth ; Ikoona, Eric. / Ascertaining baseline levels of antiretroviral therapy adherence in Uganda : a multimethod approach. In: Journal of acquired immune deficiency syndromes : JAIDS. . 2010 ; Vol. 55, No. 2. pp. 221-224.
@article{f88f55dc3282427e9cf87684d56f8775,
title = "Ascertaining baseline levels of antiretroviral therapy adherence in Uganda: a multimethod approach",
abstract = "Background: Many antiretroviral treatment (ART) adherence measurement methods have been employed by different studies, but no single method has been found to be appropriate for all settings. This study aimed to determine baseline levels of adherence using 2 measures of adherence.Methods: Levels of adherence in 967 patients continuing to receive ART in 4 health facilities were assessed over a 28-week period using a clinic-based pill count method and a patient self-report questionnaire. Factors associated with adherence were also determined.Results: Mean adherence (95{\%} confidence interval) was 97.3{\%} (96.8{\%} to 97.9{\%}) and 98.4{\%} (97.9{\%} to 98.8{\%}) for the clinic-based pill count and patient self-report methods, respectively. Proportion of clients achieving optimal adherence (≥95{\%}) was 89.9{\%} by pill count and 94.2{\%} by self-report. The 2 adherence measures were closely correlated with each other (r = 0.87, P = 0.000). Adherence increased with age (P = 0.014) with patients aged 40 years and below being less likely to achieve optimal adherence [odds ratio = 0.55; 95{\%} confidence interval (0.34 to 0.89)].Conclusions: There is a very high level of optimal adherence among patients still on treatment. The combined use of these 2 replicable and reliable methods of measuring adherence is vital to ART programs in resource-constrained settings.",
keywords = "adolescent, adult, age factors, anti-HIV agents, confidence intervals, female, HIV infections, humans, linear models, male, medication adherence, middle aged, multivariate analysis, odds ratio, prospective studies, questionnaires, Uganda, young adult",
author = "Setor Kunutsor and Morgan Evans and Janine Thoulass and John Walley and Elly Katabira and Newell, {James N} and Simon Muchuro and Hudson Balidawa and Elizabeth Namagala and Eric Ikoona",
year = "2010",
month = "10",
day = "1",
doi = "10.1097/QAI.0b013e3181e255ec",
language = "English",
volume = "55",
pages = "221--224",
journal = "Journal of acquired immune deficiency syndromes : JAIDS.",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Ascertaining baseline levels of antiretroviral therapy adherence in Uganda

T2 - a multimethod approach

AU - Kunutsor, Setor

AU - Evans, Morgan

AU - Thoulass, Janine

AU - Walley, John

AU - Katabira, Elly

AU - Newell, James N

AU - Muchuro, Simon

AU - Balidawa, Hudson

AU - Namagala, Elizabeth

AU - Ikoona, Eric

PY - 2010/10/1

Y1 - 2010/10/1

N2 - Background: Many antiretroviral treatment (ART) adherence measurement methods have been employed by different studies, but no single method has been found to be appropriate for all settings. This study aimed to determine baseline levels of adherence using 2 measures of adherence.Methods: Levels of adherence in 967 patients continuing to receive ART in 4 health facilities were assessed over a 28-week period using a clinic-based pill count method and a patient self-report questionnaire. Factors associated with adherence were also determined.Results: Mean adherence (95% confidence interval) was 97.3% (96.8% to 97.9%) and 98.4% (97.9% to 98.8%) for the clinic-based pill count and patient self-report methods, respectively. Proportion of clients achieving optimal adherence (≥95%) was 89.9% by pill count and 94.2% by self-report. The 2 adherence measures were closely correlated with each other (r = 0.87, P = 0.000). Adherence increased with age (P = 0.014) with patients aged 40 years and below being less likely to achieve optimal adherence [odds ratio = 0.55; 95% confidence interval (0.34 to 0.89)].Conclusions: There is a very high level of optimal adherence among patients still on treatment. The combined use of these 2 replicable and reliable methods of measuring adherence is vital to ART programs in resource-constrained settings.

AB - Background: Many antiretroviral treatment (ART) adherence measurement methods have been employed by different studies, but no single method has been found to be appropriate for all settings. This study aimed to determine baseline levels of adherence using 2 measures of adherence.Methods: Levels of adherence in 967 patients continuing to receive ART in 4 health facilities were assessed over a 28-week period using a clinic-based pill count method and a patient self-report questionnaire. Factors associated with adherence were also determined.Results: Mean adherence (95% confidence interval) was 97.3% (96.8% to 97.9%) and 98.4% (97.9% to 98.8%) for the clinic-based pill count and patient self-report methods, respectively. Proportion of clients achieving optimal adherence (≥95%) was 89.9% by pill count and 94.2% by self-report. The 2 adherence measures were closely correlated with each other (r = 0.87, P = 0.000). Adherence increased with age (P = 0.014) with patients aged 40 years and below being less likely to achieve optimal adherence [odds ratio = 0.55; 95% confidence interval (0.34 to 0.89)].Conclusions: There is a very high level of optimal adherence among patients still on treatment. The combined use of these 2 replicable and reliable methods of measuring adherence is vital to ART programs in resource-constrained settings.

KW - adolescent

KW - adult

KW - age factors

KW - anti-HIV agents

KW - confidence intervals

KW - female

KW - HIV infections

KW - humans

KW - linear models

KW - male

KW - medication adherence

KW - middle aged

KW - multivariate analysis

KW - odds ratio

KW - prospective studies

KW - questionnaires

KW - Uganda

KW - young adult

U2 - 10.1097/QAI.0b013e3181e255ec

DO - 10.1097/QAI.0b013e3181e255ec

M3 - Article

VL - 55

SP - 221

EP - 224

JO - Journal of acquired immune deficiency syndromes : JAIDS.

JF - Journal of acquired immune deficiency syndromes : JAIDS.

SN - 1525-4135

IS - 2

ER -