Cargando…
Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania
BACKGROUND: Measurement of adherence to antiretroviral therapy (ART) can serve as a proxy for virologic failure in resource-limited settings. The aim of this study was to determine the factors underlying nonadherence measured by three methods. PATIENTS AND METHODS: This is a prospective longitudinal...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109655/ https://www.ncbi.nlm.nih.gov/pubmed/30174460 http://dx.doi.org/10.2147/DHPS.S143178 |
_version_ | 1783350361061326848 |
---|---|
author | Sangeda, Raphael Z Mosha, Fausta Aboud, Said Kamuhabwa, Appolinary Chalamilla, Guerino Vercauteren, Jurgen Van Wijngaerden, Eric Lyamuya, Eligius F Vandamme, Anne-Mieke |
author_facet | Sangeda, Raphael Z Mosha, Fausta Aboud, Said Kamuhabwa, Appolinary Chalamilla, Guerino Vercauteren, Jurgen Van Wijngaerden, Eric Lyamuya, Eligius F Vandamme, Anne-Mieke |
author_sort | Sangeda, Raphael Z |
collection | PubMed |
description | BACKGROUND: Measurement of adherence to antiretroviral therapy (ART) can serve as a proxy for virologic failure in resource-limited settings. The aim of this study was to determine the factors underlying nonadherence measured by three methods. PATIENTS AND METHODS: This is a prospective longitudinal cohort of 220 patients on ART at Amana Hospital in Dar es Salaam, Tanzania. We measured adherence using a structured questionnaire combining a visual analog scale (VAS) and Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ), pharmacy refill, and appointment keeping during four periods over 1 year. Overall adherence was calculated as the mean adherence for all time points over the 1 year of follow-up. At each time point, adherence was defined as achieving a validated cutoff for adherence previously defined for each method. RESULTS: The proportion of overall adherence was 86.4% by VAS, 69% by SHCS-AQ, 79.8% by appointment keeping, and 51.8% by pharmacy refill. Forgetfulness was the major reported reason for patients to skip their medications. In multivariate analysis, significant predictors to good adherence were older age, less alcohol consumption, more advanced World Health Organization clinical staging, and having a lower body mass index with odds ratio (CI): 3.11 (1.55–6.93), 0.24 (0.09–0.62), 1.78 (1.14–2.84), and 0.93 (0.88–0.98), respectively. CONCLUSION: We found relatively good adherence to ART in this setting. Barriers to adherence include young age and perception of well-being. |
format | Online Article Text |
id | pubmed-6109655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-61096552018-08-31 Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania Sangeda, Raphael Z Mosha, Fausta Aboud, Said Kamuhabwa, Appolinary Chalamilla, Guerino Vercauteren, Jurgen Van Wijngaerden, Eric Lyamuya, Eligius F Vandamme, Anne-Mieke Drug Healthc Patient Saf Original Research BACKGROUND: Measurement of adherence to antiretroviral therapy (ART) can serve as a proxy for virologic failure in resource-limited settings. The aim of this study was to determine the factors underlying nonadherence measured by three methods. PATIENTS AND METHODS: This is a prospective longitudinal cohort of 220 patients on ART at Amana Hospital in Dar es Salaam, Tanzania. We measured adherence using a structured questionnaire combining a visual analog scale (VAS) and Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ), pharmacy refill, and appointment keeping during four periods over 1 year. Overall adherence was calculated as the mean adherence for all time points over the 1 year of follow-up. At each time point, adherence was defined as achieving a validated cutoff for adherence previously defined for each method. RESULTS: The proportion of overall adherence was 86.4% by VAS, 69% by SHCS-AQ, 79.8% by appointment keeping, and 51.8% by pharmacy refill. Forgetfulness was the major reported reason for patients to skip their medications. In multivariate analysis, significant predictors to good adherence were older age, less alcohol consumption, more advanced World Health Organization clinical staging, and having a lower body mass index with odds ratio (CI): 3.11 (1.55–6.93), 0.24 (0.09–0.62), 1.78 (1.14–2.84), and 0.93 (0.88–0.98), respectively. CONCLUSION: We found relatively good adherence to ART in this setting. Barriers to adherence include young age and perception of well-being. Dove Medical Press 2018-08-21 /pmc/articles/PMC6109655/ /pubmed/30174460 http://dx.doi.org/10.2147/DHPS.S143178 Text en © 2018 Sangeda et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Sangeda, Raphael Z Mosha, Fausta Aboud, Said Kamuhabwa, Appolinary Chalamilla, Guerino Vercauteren, Jurgen Van Wijngaerden, Eric Lyamuya, Eligius F Vandamme, Anne-Mieke Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title | Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title_full | Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title_fullStr | Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title_full_unstemmed | Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title_short | Predictors of non adherence to antiretroviral therapy at an urban HIV care and treatment center in Tanzania |
title_sort | predictors of non adherence to antiretroviral therapy at an urban hiv care and treatment center in tanzania |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109655/ https://www.ncbi.nlm.nih.gov/pubmed/30174460 http://dx.doi.org/10.2147/DHPS.S143178 |
work_keys_str_mv | AT sangedaraphaelz predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT moshafausta predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT aboudsaid predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT kamuhabwaappolinary predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT chalamillaguerino predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT vercauterenjurgen predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT vanwijngaerdeneric predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT lyamuyaeligiusf predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania AT vandammeannemieke predictorsofnonadherencetoantiretroviraltherapyatanurbanhivcareandtreatmentcenterintanzania |