Pharmacy adherence measures to assess adherence to antiretroviral therapy: review of the literature and implications for treatment monitoring.
Prescription or pill-based methods for estimating adherence to antiretroviral therapy (ART), pharmacy adherence measures (PAMs), are objective estimates calculated from routinely collected pharmacy data. We conducted a literature review to evaluate PAMs, including their association with virological and other clinical outcomes, their efficacy compared with other adherence measures, and factors to consider when selecting a PAM to monitor adherence. PAMs were classified into 3 categories: medication possession ratio (MPR), pill count (PC), and pill pick-up (PPU). Data exist to recommend PAMs over self-reported adherence. PAMs consistently predicted patient outcomes, but additional studies are needed to determine the most predictive PAM parameters. Current evidence suggests that shorter duration of adherence assessment (≤ 6 months) and use of PAMs to predict future outcomes may be less accurate. PAMs which incorporate the number of days for which ART was prescribed without the counting of remnant pills, are reasonable minimum-resource methods to assess adherence to ART.
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston MA, USA. ames.mcmahon@tufts.edu
James H
JH
McMahon
Michael R
MR
Jordan
Karen
K
Kelley
Silvia
S
Bertagnolio
Steven Y
SY
Hong
Christine A
CA
Wanke
Sharon R
SR
Lewin
Julian H
JH
Elliott
D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010604:Pharmacy / Q000379:methods*; D016896:Treatment Outcome; D016903:Drug Monitoring
D019380:Anti-HIV Agents
J Infect Dis. 2005 Feb 1;191(3):339-47
15633092
AIDS Res Hum Retroviruses. 2008 Oct;24(10):1263-8
18834323
AIDS. 2002 May 3;16(7):1051-8
11953472
Clin Infect Dis. 2004 May 1;38(9):1311-6
15127346
Clin Infect Dis. 2005 Jan 1;40(1):158-63
15614706
Int J Epidemiol. 2009 Jun;38(3):746-56
19223334
AIDS. 2008 Apr 23;22(7):873-82
18427206
Lancet. 2006 Mar 11;367(9513):817-24
16530575
AIDS Res Ther. 2009 Oct 12;6:21
19821997
Clin Infect Dis. 2006 Oct 1;43(7):939-41
16941380
J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):301-6
16249704
J Infect Dis. 2006 Oct 15;194(8):1108-14
16991085
Lancet. 2003 Jul 5;362(9377):22-9
12853195
Clin Infect Dis. 1999 Oct;29(4):824-30
10589897
CMAJ. 2003 Sep 30;169(7):656-61
14517122
Clin Infect Dis. 2001 Sep 1;33(5):700-5
11486292
J Acquir Immune Defic Syndr. 1999 Dec 1;22(4):358-63
10634197
J Acquir Immune Defic Syndr. 2004 Mar 1;35(3):261-8
15076240
AIDS Care. 2008 Jul;20(6):741-5
18576177
J Clin Epidemiol. 2004 Oct;57(10):1107-10
15528063
N Engl J Med. 1998 Mar 26;338(13):853-60
9516219
HIV Med. 2010 Mar;11(3):216-24
20002781
Lancet. 2006 Nov 4;368(9547):1587-94
17084759
Am J Health Syst Pharm. 2002 Mar 1;59(5):447-52
11887411
Ann Intern Med. 2001 May 15;134(10):968-77
11352698
J Acquir Immune Defic Syndr. 2002 May 1;30(1):105-10
12048370
Ann Intern Med. 2007 Apr 17;146(8):564-73
17438315
Clin Infect Dis. 2003 Oct 15;37(8):1112-8
14523777
HIV Med. 2005 Sep;6(5):366-9
16156886
AIDS Care. 2009 Jul;21(7):842-50
20024740
Clin Ther. 2007 Apr;29(4):711-6
17617294
Int J STD AIDS. 2004 Dec;15(12):803-10
15601486
AIDS Res Hum Retroviruses. 2008 Aug;24(8):1031-5
18724803
J Acquir Immune Defic Syndr. 2000 Apr 1;23(4):360-1
10836763
BMC Health Serv Res. 2010 Feb 19;10:42
20170478
Pharmacotherapy. 2005 Jun;25(6):790-6
15927896
J Acquir Immune Defic Syndr. 2010 Feb;53(2):159-61
19861899
PLoS One. 2009 Sep 29;4(9):e7196
19787058
J Acquir Immune Defic Syndr. 2003 Jun 1;33(2):253-8
12794563
AIDS. 2007 May 11;21(8):965-71
17457090
J Infect Dis. 2008 May 15;197 Suppl 3:S272-8
18447613
J Infect Dis. 2005 Jun 15;191(12):2046-52
15897990
Clin Infect Dis. 2008 May 15;46(10):1609-16
18419498
PLoS Med. 2008 May 20;5(5):e109
18494555
J Acquir Immune Defic Syndr. 2006 Sep;43(1):78-84
16878045
Ann Intern Med. 2000 Jul 4;133(1):21-30
10877736
Am J Health Syst Pharm. 2007 Dec 15;64(24):2574-8
18056946
AIDS Patient Care STDS. 2004 Dec;18(12):728-35
15659884
JAMA. 2000 Jan 12;283(2):205-11
10634336
AIDS. 2006 Jan 9;20(2):223-31
16511415
J Manag Care Pharm. 2009 Jan-Feb;15(1):32-41
19125548
J Acquir Immune Defic Syndr. 2008 Sep 1;49(1):107-10
18667926
AIDS Res Hum Retroviruses. 2009 Aug;25(8):783-93
19619008
AIDS. 2007 Jul 31;21(12):1579-89
17630553
J Acquir Immune Defic Syndr. 2009 Apr 15;50(5):529-36
19223785