A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

H. M. Crane; R. M. Nance; J. A.C. Delaney; R. J. Fredericksen; A. Church; J. M. Simoni; R. D. Harrington; S. Dhanireddy; S. A. Safren; M. E. McCaul; W. B. Lober; P. K. Crane; I. B. Wilson; M. J. Mugavero; M. M. Kitahata

doi:10.1007/s10461-016-1566-8

A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

H. M. Crane, R. M. Nance, J. A.C. Delaney, R. J. Fredericksen, A. Church, J. M. Simoni, R. D. Harrington, S. Dhanireddy, S. A. Safren, M. E. McCaul, W. B. Lober, P. K. Crane, I. B. Wilson, M. J. Mugavero, M. M. Kitahata

School of Medicine

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.

Original language	English (US)
Pages (from-to)	470-480
Number of pages	11
Journal	AIDS and behavior
Volume	21
Issue number	2
DOIs	https://doi.org/10.1007/s10461-016-1566-8
State	Published - Feb 1 2017

Keywords

Adherence
Depression
Hazardous alcohol use
Substance use
Viral load

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

Access to Document

10.1007/s10461-016-1566-8

Cite this

Crane, H. M., Nance, R. M., Delaney, J. A. C., Fredericksen, R. J., Church, A., Simoni, J. M., Harrington, R. D., Dhanireddy, S., Safren, S. A., McCaul, M. E., Lober, W. B., Crane, P. K., Wilson, I. B., Mugavero, M. J., & Kitahata, M. M. (2017). A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better? AIDS and behavior, 21(2), 470-480. https://doi.org/10.1007/s10461-016-1566-8

Crane, HM, Nance, RM, Delaney, JAC, Fredericksen, RJ, Church, A, Simoni, JM, Harrington, RD, Dhanireddy, S, Safren, SA, McCaul, ME, Lober, WB, Crane, PK, Wilson, IB, Mugavero, MJ & Kitahata, MM 2017, 'A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?', AIDS and behavior, vol. 21, no. 2, pp. 470-480. https://doi.org/10.1007/s10461-016-1566-8

@article{d307be4e75804344800f0b951fda8fd7,

title = "A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?",

abstract = "Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.",

keywords = "Adherence, Depression, Hazardous alcohol use, Substance use, Viral load",

author = "Crane, {H. M.} and Nance, {R. M.} and Delaney, {J. A.C.} and Fredericksen, {R. J.} and A. Church and Simoni, {J. M.} and Harrington, {R. D.} and S. Dhanireddy and Safren, {S. A.} and McCaul, {M. E.} and Lober, {W. B.} and Crane, {P. K.} and Wilson, {I. B.} and Mugavero, {M. J.} and Kitahata, {M. M.}",

note = "Funding Information: This work was supported by the National Institutes of Mental Health (NIMH) at the National Institutes of Health [R01 MH084759] and the Office of Behavioral and Social Sciences Research at the National Institutes of Health [U01AR057954-S]. Additional support came from the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757] and the National Institutes of Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health [U24AA020801, U01AA020793 and U01AA020802]. Publisher Copyright: {\textcopyright} 2016, Springer Science+Business Media New York.",

year = "2017",

month = feb,

day = "1",

doi = "10.1007/s10461-016-1566-8",

language = "English (US)",

volume = "21",

pages = "470--480",

journal = "AIDS and Behavior",

issn = "1090-7165",

publisher = "Springer New York",

number = "2",

}

TY - JOUR

T1 - A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care

T2 - Is Longer Better?

AU - Crane, H. M.

AU - Nance, R. M.

AU - Delaney, J. A.C.

AU - Fredericksen, R. J.

AU - Church, A.

AU - Simoni, J. M.

AU - Harrington, R. D.

AU - Dhanireddy, S.

AU - Safren, S. A.

AU - McCaul, M. E.

AU - Lober, W. B.

AU - Crane, P. K.

AU - Wilson, I. B.

AU - Mugavero, M. J.

AU - Kitahata, M. M.

N1 - Funding Information: This work was supported by the National Institutes of Mental Health (NIMH) at the National Institutes of Health [R01 MH084759] and the Office of Behavioral and Social Sciences Research at the National Institutes of Health [U01AR057954-S]. Additional support came from the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757] and the National Institutes of Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health [U24AA020801, U01AA020793 and U01AA020802]. Publisher Copyright: © 2016, Springer Science+Business Media New York.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.

AB - Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.

KW - Adherence

KW - Depression

KW - Hazardous alcohol use

KW - Substance use

KW - Viral load

UR - http://www.scopus.com/inward/record.url?scp=84990842054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990842054&partnerID=8YFLogxK

U2 - 10.1007/s10461-016-1566-8

DO - 10.1007/s10461-016-1566-8

M3 - Article

C2 - 27714525

AN - SCOPUS:84990842054

SN - 1090-7165

VL - 21

SP - 470

EP - 480

JO - AIDS and Behavior

JF - AIDS and Behavior

IS - 2

ER -

A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this