title: Comprehensive evaluation of caregiver-reported antiretroviral therapy adherence for HIV-infected children.
abstract: For HIV-infected children, adherence to antiretroviral therapy (ART) is often assessed by caregiver report but there are few data on their validity. We conducted prospective evaluations with 191 children ages 0-14 years and their caregivers over 6 months in western Kenya to identify questionnaire items that best predicted adherence to ART. Medication Event Monitoring Systems(®) (MEMS, MWV/AARDEX Ltd., Switzerland) electronic dose monitors were used as external criterion for adherence. We employed a novel variable selection tool using the LASSO technique with logistic regression to identify items best correlated with dichotomized MEMS adherence (≥90 or <90 % doses taken). Nine of 48 adherence items were identified as the best predictors of adherence, including missed or late doses in the past 7 days, problems giving the child medicines, and caregiver-level factors like not being present at medication taking. These items could be included in adherence assessment tools for pediatric patients.
authors.affiliation: Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10th Street, HITS Suite 1000, Indianapolis, IN, 46202, USA, rvreeman@iu.edu.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Vreeman
authors.forename: Winstone M
authors.initials: WM
authors.lastname: Nyandiko
authors.forename: Hai
authors.initials: H
authors.lastname: Liu
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Scanlon
authors.forename: James E
authors.initials: JE
authors.lastname: Slaven
authors.forename: Samuel O
authors.initials: SO
authors.lastname: Ayaya
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Inui
mesh_terms: D000293:Adolescent; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000627:therapeutic use; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D016015:Logistic Models; D008297:Male; D019829:Nevirapine / Q000627:therapeutic use; D010290:Parents; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019829:Nevirapine; C098320:efavirenz