title: Evaluation of the single-item self-rating adherence scale for use in routine clinical care of people living with HIV.
abstract: The self-rating scale item (SRSI) is a single-item self-report adherence measure that uses adjectives in a 5-point Likert scale, from "very poor" to "excellent," to describe medication adherence over the past 4 weeks. This study investigated the SRSI in 2,399 HIV-infected patients in routine care at two outpatient primary HIV clinics. Correlations between the SRSI and four commonly used adherence items ranged from 0.37 to 0.64. Correlations of adherence barriers, such as depression and substance use, were comparable across all adherence items. General estimating equations suggested the SRSI is as good as or better than other adherence items (p's <0.001 vs. <0.001-0.99) at predicting adherence-related clinical outcomes, such as HIV viral load and CD4(+) cell count. These results and the SRSI's low patient burden suggest its routine use could be helpful for assessing adherence in clinical care and should be more widespread, particularly where more complex instruments may be impractical.
authors.affiliation: Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA 98104, USA. bjfeld@uw.edu
authors.forename: B J
authors.initials: BJ
authors.lastname: Feldman
authors.forename: R J
authors.initials: RJ
authors.lastname: Fredericksen
authors.forename: P K
authors.initials: PK
authors.lastname: Crane
authors.forename: S A
authors.initials: SA
authors.lastname: Safren
authors.forename: M J
authors.initials: MJ
authors.lastname: Mugavero
authors.forename: James H
authors.initials: JH
authors.lastname: Willig
authors.forename: J M
authors.initials: JM
authors.lastname: Simoni
authors.forename: I B
authors.initials: IB
authors.lastname: Wilson
authors.forename: M S
authors.initials: MS
authors.lastname: Saag
authors.forename: M M
authors.initials: MM
authors.lastname: Kitahata
authors.forename: H M
authors.initials: HM
authors.lastname: Crane
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010147:Pain Measurement; D011581:Psychological Tests; D057566:Self Report; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents