The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy.
The Center for Adherence Support Evaluation (CASE) Adherence Index, a simple composite measure of self-reported antiretroviral therapy (ART) adherence, was compared to a standard three-day self-reported adherence measure among participants in a longitudinal, prospective cross-site evaluation of 12 adherence programs throughout the United States. The CASE Adherence Index, consisting of three unique adherence questions developed for the cross-site study, along with a three-day adherence self-report were administered by interviews every three months over a one-year period. Data from the three cross-site adherence questions (individually and in combination) were compared to three -day self-report data and HIV RNA and CD4 outcomes in cross-sectional analyses. The CASE Adherence Index correlated strongly with the three-day self-reported adherence data (p < 0.001) and was more strongly associated with HIV outcomes, including a 1-log decline in HIV RNA level (maximum OR = 2.34; p < 0.05), HIV RNA < 400 copies/ml (maximum OR = 2.33; p < 0.05) and performed as well as the three-day self-report when predicting CD4 count status. Participants with a CASE Index score >10 achieved a 98 cell mean increase in CD4 count over 12 months, compared to a 41 cell increase for those with scores < or =10 (p < 0.05). The CASE Adherence Index is an easy to administer instrument that provides an alternative method for assessing ART adherence in clinical settings.
Mannheimer
S B
SB
Harlem Hospital Center, Columbia University, New York, NY, USA.
Mukherjee
R
R
Hirschhorn
L R
LR
Dougherty
J
J
Celano
S A
SA
Ciccarone
D
D
Graham
K K
KK
Mantell
J E
JE
Mundy
L M
LM
Eldred
L
L
Botsko
Michael
M
Finkelstein
R
R
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D012646:Self Administration / Q000523:psychology*; D014481:United States