title: The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy.
abstract: 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.
authors.affiliation: Harlem Hospital Center, Columbia University, New York, NY, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Mannheimer
authors.forename: R
authors.initials: R
authors.lastname: Mukherjee
authors.forename: L R
authors.initials: LR
authors.lastname: Hirschhorn
authors.forename: J
authors.initials: J
authors.lastname: Dougherty
authors.forename: S A
authors.initials: SA
authors.lastname: Celano
authors.forename: D
authors.initials: D
authors.lastname: Ciccarone
authors.forename: K K
authors.initials: KK
authors.lastname: Graham
authors.forename: J E
authors.initials: JE
authors.lastname: Mantell
authors.forename: L M
authors.initials: LM
authors.lastname: Mundy
authors.forename: L
authors.initials: L
authors.lastname: Eldred
authors.forename: Michael
authors.initials: M
authors.lastname: Botsko
authors.forename: R
authors.initials: R
authors.lastname: Finkelstein
mesh_terms: 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