title: Antiretroviral Refill Adherence Correlates with, But Poorly Predicts Retention in HIV Care.
abstract: If antiretroviral refill adherence could predict non-retention in care, it could be clinically useful. In a retrospective cohort study of HIV-infected adults in Philadelphia between October 2012 and April 2013, retention in care was measured by show versus no-show at an index visit. Three measures of adherence were defined per person: (1) percent of doses taken for two refills nearest index visit, (2) days late for last refill before index visit, and (3) longest gap between any two refills. Of 393 patients, 108 (27.4 %) no-showed. Adherence was higher in the show group on all measures with longest gap having the greatest difference: 40 days (IQR 33-56) in the show versus 47 days (IQR 38-69) in the no-show group, p < 0.001. Yet, no cut-points of adherence adequately predicted show versus no-show. Antiretroviral adherence being associated, but a poor predictor of retention suggests that these two behaviors are related but distinct phenomena.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
authors.forename: Robert A
authors.identifier: 0000-0002-7989-2093
authors.initials: RA
authors.lastname: Bonacci
authors.affiliation: Department of Medicine (Infectious Diseases), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Frasca
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
authors.forename: Lyles
authors.initials: L
authors.lastname: Swift
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
authors.forename: Daohang
authors.initials: D
authors.lastname: Sha
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.
authors.forename: Warren B
authors.initials: WB
authors.lastname: Bilker
authors.affiliation: Department of Medicine (Infectious Diseases), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|The Jonathan Lax Treatment Center, Philadelphia FIGHT, Philadelphia, PA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Bamford
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA.|Department of Medicine (Infectious Diseases), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Department of Medicine (Infectious Diseases), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
authors.forename: Baligh R
authors.initials: BR
authors.lastname: Yehia
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 804 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA. grossr@mail.med.upenn.edu.|Department of Medicine (Infectious Diseases), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. grossr@mail.med.upenn.edu.|Department of Medicine (Infectious Diseases), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA. grossr@mail.med.upenn.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D015143:Philadelphia; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; Antiretroviral therapy; HIV; Monitoring; Retention in care