title: Multiple self-report measures of antiretroviral adherence correlated in Sierra Leone, but did they agree?
abstract: In resource-poor settings, studies validating multiple self-report measures of adherence are limited and do not include data from West Africa. We prospectively assessed the associations between multiple self-report measures of adherence in 58 patients receiving antiretroviral therapy. Self-report measures included a 30-day visual analog scale, 30-day qualitative single-item measure, Adult AIDS Clinical Trial Group 4-day recall, and 3-level categorical 7-day qualitative measure. Unannounced pill count was the objective measure. Spearman's rho correlation coefficients, Bland-Altman plots, and receiver operator curve analyses were performed. Median and mean adherence by pill count were 81.8% and 78.6%, respectively. All self-report measures had either intermediate or high correlation with the pill count, and the 7-day measure had the highest level of correlation with pill count (r = 0.72). All self-report measures demonstrated good agreement when mean pill count adherence was greater than 90%. All but the 7-day measure posed challenges to patient understanding and administration of the measure. In this sample of participants that displayed largely suboptimal adherence, the 7-day measure was preferable, but all self-report measures demonstrated relatively good agreement with the objective criterion pill count measure and are adequate for clinical use in settings such as Sierra Leone.
authors: Baylor College of Medicine, Houston, USA.
authors: J Daniel
authors: JD
authors: Kelly
authors: Erica A
authors: EA
authors: Hubenthal
authors: Gregoire
authors: G
authors: Lurton
authors: Susannah F
authors: SF
authors: Empson
authors: M Bailor
authors: MB
authors: Barrie
authors: Brima
authors: B
authors: Kargbo
authors: Glenn J
authors: GJ
authors: Wagner
authors: Thomas P
authors: TP
authors: Giordano
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D036301:Qualitative Research; D012372:ROC Curve; D015203:Reproducibility of Results; D057566:Self Report; D012807:Sierra Leone; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV/AIDS; Sierra Leone; adherence; antiretroviral therapy; self-report; sub-Saharan Africa; treatment; validation