title: The Antiretroviral Regimen Complexity Index. A novel method of quantifying regimen complexity.
abstract: BACKGROUND
  Individuals with HIV disease often must adhere to complex medication regimens. To date, regimen complexity has not been examined in the literature using standardized procedures incorporating all important elements of antiretroviral (ARV) regimens.
  
  
  OBJECTIVE
  This article presents a novel method of quantifying regimen complexity using objective criteria addressing the factors that may complicate adherence to ARV regimens.
  
  
  METHODS
  Part 1 of this article describes the development of the Antiretroviral Regimen Complexity (ARC) Index scoring system. Based on input from pediatric and adult patients, caregivers of pediatric patients, and health care professionals, this comprehensive system includes the number of medications, dosing schedules, administration methods, special instructions, and required preparations associated with ARV regimens. Weights are applied for each of these factors to produce an overall score representing the regimen's level of complexity. Part 2 of this article presents reliability and validity data for the system.
  
  
  RESULTS
  The ARC Index demonstrates excellent test-retest and interrater reliability as well as strong construct and discriminant validity. An on-line version of this system minimizes computation errors.
  
  
  CONCLUSIONS
  Although modifications may be necessary for patients requiring nonstandard dosing instructions, preliminary evidence supports the utility of this measure as a reliable and valid indicator of the complexity of antiretroviral treatment regimens.
authors.affiliation: Center for Cancer Research, National Cancer Institute, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD 20892-8200, USA. martins@mail.nih.gov
authors.forename: Staci
authors.initials: S
authors.lastname: Martin
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Wolters
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Calabrese
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Toledo-Tamula
authors.forename: Lauren V
authors.initials: LV
authors.lastname: Wood
authors.forename: Gregg
authors.initials: G
authors.lastname: Roby
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Elliott-DeSorbo
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D023801:Directly Observed Therapy / Q000379:methods* / Q000592:standards; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010349:Patient Compliance
chemical_list: D019380:Anti-HIV Agents