title: Adherence to antiretroviral therapy in children: a comparative evaluation of caregiver reports and physician judgement.
abstract: Adherence to antiretroviral (ART) therapy, as reported by children caregivers, was investigated and compared with physicians' estimates of adherence. Two parallel structured questionnaires were administered to caregivers of 129 HIV-infected children and to their physicians in seven different Italian reference centers. Doses omitted in the last four days were recorded. Perfect adherence (>95% of prescribed doses taken in the last four days before interview) was reported by caregivers of 103 (79%) children. Five children (5%) omitted one dose of any ART drug in four days and were considered adherent. Low (<95 but >80% of doses) and poor (<80% of doses) adherence were reported by 15 (12%) and six (5%) caregivers, respectively. Forty-eight children (37%) were judged to be non-adherent by their physicians, including 35 children who were receiving all the prescribed doses according to caregivers. The physicians identified eight out of the 21 non-adherent children as adherent. Non-adherence estimates by physicians closely correlated with poor clinical conditions. These data indicate that adherence is a major problem but there is a clear discrepancy between caregiver reports and physician judgement. The results underline the need of close surveillance of adherence in HIV-positive children in order to evaluate the effectiveness of ART therapy.
authors.affiliation: Department of Pediatrics, University Federico II, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Albano
authors.forename: V
authors.initials: V
authors.lastname: Giacomet
authors.forename: G
authors.initials: G
authors.lastname: De Marco
authors.forename: E
authors.initials: E
authors.lastname: Bruzzese
authors.forename: F
authors.initials: F
authors.lastname: Starace
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
mesh_terms: D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D017028:Caregivers / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007223:Infant; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008503:Medical Staff; D010349:Patient Compliance / Q000706:statistics & numerical data
chemical_list: D044966:Anti-Retroviral Agents