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The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings

BACKGROUND: Pill counts are often used to measure adherence to ART, but there is little data on how they affect adherence. We previously showed a bivariate relationship between clinicians counting pills and adherence in patients receiving HIV care in Kenya. We present a secondary analysis of the rel...

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Autores principales: Achieng, Loice, Musangi, Helen, Billingsley, Katherine, Onguit, Sharon, Ombegoh, Edwin, Bryant, LeeAnn, Mwiindi, Jonathan, Smith, Nathaniel, Keiser, Philip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855050/
https://www.ncbi.nlm.nih.gov/pubmed/24339861
http://dx.doi.org/10.1371/journal.pone.0067259
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author Achieng, Loice
Musangi, Helen
Billingsley, Katherine
Onguit, Sharon
Ombegoh, Edwin
Bryant, LeeAnn
Mwiindi, Jonathan
Smith, Nathaniel
Keiser, Philip
author_facet Achieng, Loice
Musangi, Helen
Billingsley, Katherine
Onguit, Sharon
Ombegoh, Edwin
Bryant, LeeAnn
Mwiindi, Jonathan
Smith, Nathaniel
Keiser, Philip
author_sort Achieng, Loice
collection PubMed
description BACKGROUND: Pill counts are often used to measure adherence to ART, but there is little data on how they affect adherence. We previously showed a bivariate relationship between clinicians counting pills and adherence in patients receiving HIV care in Kenya. We present a secondary analysis of the relationship between numbers of pill counts and clinical outcomes in resource limited settings METHODS: Patients initiating ART at Kijabe Hospital were monitored for the number of discretionary pill counts performed by their clinician in the first 6 months of ART. Subjects were followed for at least 1 year after enrollment. The number of clinician pill counts was correlated to ART adherence. The primary endpoints were time to treatment failure, defined as a detectable HIV-1 viral load, death; or loss to follow-up. RESULTS: Clinician pill counts were done at 68% of clinic visits for 304 subjects. There was a positive correlation between the number of clinician pill counts and ART adherence (r = 0.21, p <0.001). Patients were divided into 3 groups (0 counts, 1 to 3 counts, 4 to 7 counts) and exhibited adherence of 76%, 84%, and 92%, respectively (p = 0.004). Time to treatment failure for these groups was 220 days, 438 days, and 497 days (P<0.01), respectively. Time to virologic failure in living patients remaining in the cohort was longer in those with more pill count (P =0.02). Multi-variate analysis adjusting for co-variates affecting time to treatment failure found that that clinician pill counts were associated with a decreased risk of treatment failure (HR = 0.69, p =0.04). CONCLUSIONS: The number of clinician pill count performed was independently associated with better adherence and a decreased risk of treatment failure. The use of clinician pill counts should be further studied as an adherence promoter through a randomized clinical trial.
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spelling pubmed-38550502013-12-11 The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings Achieng, Loice Musangi, Helen Billingsley, Katherine Onguit, Sharon Ombegoh, Edwin Bryant, LeeAnn Mwiindi, Jonathan Smith, Nathaniel Keiser, Philip PLoS One Research Article BACKGROUND: Pill counts are often used to measure adherence to ART, but there is little data on how they affect adherence. We previously showed a bivariate relationship between clinicians counting pills and adherence in patients receiving HIV care in Kenya. We present a secondary analysis of the relationship between numbers of pill counts and clinical outcomes in resource limited settings METHODS: Patients initiating ART at Kijabe Hospital were monitored for the number of discretionary pill counts performed by their clinician in the first 6 months of ART. Subjects were followed for at least 1 year after enrollment. The number of clinician pill counts was correlated to ART adherence. The primary endpoints were time to treatment failure, defined as a detectable HIV-1 viral load, death; or loss to follow-up. RESULTS: Clinician pill counts were done at 68% of clinic visits for 304 subjects. There was a positive correlation between the number of clinician pill counts and ART adherence (r = 0.21, p <0.001). Patients were divided into 3 groups (0 counts, 1 to 3 counts, 4 to 7 counts) and exhibited adherence of 76%, 84%, and 92%, respectively (p = 0.004). Time to treatment failure for these groups was 220 days, 438 days, and 497 days (P<0.01), respectively. Time to virologic failure in living patients remaining in the cohort was longer in those with more pill count (P =0.02). Multi-variate analysis adjusting for co-variates affecting time to treatment failure found that that clinician pill counts were associated with a decreased risk of treatment failure (HR = 0.69, p =0.04). CONCLUSIONS: The number of clinician pill count performed was independently associated with better adherence and a decreased risk of treatment failure. The use of clinician pill counts should be further studied as an adherence promoter through a randomized clinical trial. Public Library of Science 2013-12-05 /pmc/articles/PMC3855050/ /pubmed/24339861 http://dx.doi.org/10.1371/journal.pone.0067259 Text en © 2013 Achieng et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Achieng, Loice
Musangi, Helen
Billingsley, Katherine
Onguit, Sharon
Ombegoh, Edwin
Bryant, LeeAnn
Mwiindi, Jonathan
Smith, Nathaniel
Keiser, Philip
The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title_full The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title_fullStr The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title_full_unstemmed The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title_short The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings
title_sort use of pill counts as a facilitator of adherence with antiretroviral therapy in resource limited settings
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855050/
https://www.ncbi.nlm.nih.gov/pubmed/24339861
http://dx.doi.org/10.1371/journal.pone.0067259
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