Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://dx.doi.org/10.1097/MD.0000000000009015 http://hdl.handle.net/1843/60777 |
Resumo: | Introduction: Patient adherence to antiretroviral therapy (ART) is critical for HIV treatment success. Monitoring rates of adherence in public HIV outpatient care facilities can improve outcomes in Brazil where ART is universally available. Methods: We conducted a national cross-sectional survey of ART adherence in 2010. Participants were selected using a multistage probability sample. First, HIV outpatient care facilities were stratified according to 7 Organizational Quality Classification (OQC) groups and regions. Second, 1 or 2 facilities were selected per region for each OQC group. Finally, patients were randomly selected at each facility. In a first component, patients were invited to answer to a web-based questionnaire (WebAd-Q), a validated self-reported tool that includes 3 questions on adherence to ART in the past 7 days (time scheduling—timing, drug regimen—medication, and pill counts—dose), herein named indicators of potential nonadherence (IPN). In addition, a subsample of participants were interviewed in order to obtain further data on sociodemographic and clinical characteristics (second component). The proportion of each IPN was estimated using weighted data to account for the sampling design with 95% confidence interval (CI) and descriptive analysis was carried out. Results: Fifty-five facilities were chosen and 2424 patients completed the WebAd-Q in the first component of the study, while 598 patients were interviewed for the second component. The weighted proportions of the IPN were 50.9%, 31.8%, and 19.5%, for timing, medication, and dose, respectively, while11.7% had all 3 indicators, varying from 5.9% in the Southeast and 21.9% in the Northeast regions. Overall, 61.1% of the patients had at least 1 IPN (95% CI: 58.5–63.7%). Patients reporting depression symptoms, illicit drug use and those who missed medical appointments had worse nonadherence outcomes. Conclusions: Overall, there was a high proportion of all indicators IPN and timing was the main component associated with low adherence. Although these indicators may not necessarily indicate individual nonadherence, they represent a worrisome scenario in the public Brazilian HIV care facilities. On a routine basis, these facilities can identify gaps in providing counseling and ART orientation to their clientele and develop innovative strategies to prevent nonadherence. |
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2023-11-10T15:28:05Z2023-11-10T15:28:05Z2018-0597Suppl. 1S38S45http://dx.doi.org/10.1097/MD.00000000000090151536-5964http://hdl.handle.net/1843/60777Introduction: Patient adherence to antiretroviral therapy (ART) is critical for HIV treatment success. Monitoring rates of adherence in public HIV outpatient care facilities can improve outcomes in Brazil where ART is universally available. Methods: We conducted a national cross-sectional survey of ART adherence in 2010. Participants were selected using a multistage probability sample. First, HIV outpatient care facilities were stratified according to 7 Organizational Quality Classification (OQC) groups and regions. Second, 1 or 2 facilities were selected per region for each OQC group. Finally, patients were randomly selected at each facility. In a first component, patients were invited to answer to a web-based questionnaire (WebAd-Q), a validated self-reported tool that includes 3 questions on adherence to ART in the past 7 days (time scheduling—timing, drug regimen—medication, and pill counts—dose), herein named indicators of potential nonadherence (IPN). In addition, a subsample of participants were interviewed in order to obtain further data on sociodemographic and clinical characteristics (second component). The proportion of each IPN was estimated using weighted data to account for the sampling design with 95% confidence interval (CI) and descriptive analysis was carried out. Results: Fifty-five facilities were chosen and 2424 patients completed the WebAd-Q in the first component of the study, while 598 patients were interviewed for the second component. The weighted proportions of the IPN were 50.9%, 31.8%, and 19.5%, for timing, medication, and dose, respectively, while11.7% had all 3 indicators, varying from 5.9% in the Southeast and 21.9% in the Northeast regions. Overall, 61.1% of the patients had at least 1 IPN (95% CI: 58.5–63.7%). Patients reporting depression symptoms, illicit drug use and those who missed medical appointments had worse nonadherence outcomes. Conclusions: Overall, there was a high proportion of all indicators IPN and timing was the main component associated with low adherence. Although these indicators may not necessarily indicate individual nonadherence, they represent a worrisome scenario in the public Brazilian HIV care facilities. On a routine basis, these facilities can identify gaps in providing counseling and ART orientation to their clientele and develop innovative strategies to prevent nonadherence.Introduction: Patient adherence to antiretroviral therapy (ART) is critical for HIV treatment success. Monitoring rates of adherence in public HIV outpatient care facilities can improve outcomes in Brazil where ART is universally available. Methods: We conducted a national cross-sectional survey of ART adherence in 2010. Participants were selected using a multistage probability sample. First, HIV outpatient care facilities were stratified according to 7 Organizational Quality Classification (OQC) groups and regions. Second, 1 or 2 facilities were selected per region for each OQC group. Finally, patients were randomly selected at each facility. In a first component, patients were invited to answer to a web-based questionnaire (WebAd-Q), a validated self-reported tool that includes 3 questions on adherence to ART in the past 7 days (time scheduling—timing, drug regimen—medication, and pill counts—dose), herein named indicators of potential nonadherence (IPN). In addition, a subsample of participants were interviewed in order to obtain further data on sociodemographic and clinical characteristics (second component). The proportion of each IPN was estimated using weighted data to account for the sampling design with 95% confidence interval (CI) and descriptive analysis was carried out. Results: Fifty-five facilities were chosen and 2424 patients completed the WebAd-Q in the first component of the study, while 598 patients were interviewed for the second component. The weighted proportions of the IPN were 50.9%, 31.8%, and 19.5%, for timing, medication, and dose, respectively, while11.7% had all 3 indicators, varying from 5.9% in the Southeast and 21.9% in the Northeast regions. Overall, 61.1% of the patients had at least 1 IPN (95% CI: 58.5–63.7%). Patients reporting depression symptoms, illicit drug use and those who missed medical appointments had worse nonadherence outcomes. Conclusions: Overall, there was a high proportion of all indicators IPN and timing was the main component associated with low adherence. Although these indicators may not necessarily indicate individual nonadherence, they represent a worrisome scenario in the public Brazilian HIV care facilities. On a routine basis, these facilities can identify gaps in providing counseling and ART orientation to their clientele and develop innovative strategies to prevent nonadherence.FAPESP - Fundação de Amparo à Pesquisa do Estado de São PauloengUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE FARMÁCIA SOCIALMedicineInfecções por HIVSíndrome de imunodeficiência adquiridaBrasilPesquisa sobre serviços de saúdeAdesão à medicaçãoAntiretroviral therapyBrazilHealth services researchHIV/AIDSNational surveyNonadherenceMonitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://journals.lww.com/md-journal/fulltext/2018/05251/monitoring_self_reported_adherence_to.3.aspxMaria Altenfelder SantosMark Drew Crosland GuimarãesErnani Tiaraju Santa HelenaCáritas Relva BassoFelipe Campos do ValeWania Maria do Espírito Santo CarvalhoAna Maroso AlvesGustavo Machado RochaFrancisco de Assis AcurcioMaria das Graças Braga CeccatoRogério Ruscitto do PradoPaulo Rossi MenezesMaria Ines Battistella Nemesapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/60777/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALMonitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil a national cross-sectional study.pdfMonitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil a national cross-sectional study.pdfapplication/pdf233627https://repositorio.ufmg.br/bitstream/1843/60777/2/Monitoring%20self-reported%20adherence%20to%20antiretroviral%20therapy%20in%20public%20HIV%20care%20facilities%20in%20Brazil%20a%20national%20cross-sectional%20study.pdfa462a86a771f473940efb33a1b782d17MD521843/607772023-11-10 17:40:31.061oai:repositorio.ufmg.br:1843/60777Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-11-10T20:40:31Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
title |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
spellingShingle |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study Maria Altenfelder Santos Antiretroviral therapy Brazil Health services research HIV/AIDS National survey Nonadherence Infecções por HIV Síndrome de imunodeficiência adquirida Brasil Pesquisa sobre serviços de saúde Adesão à medicação |
title_short |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
title_full |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
title_fullStr |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
title_full_unstemmed |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
title_sort |
Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: a national cross-sectional study |
author |
Maria Altenfelder Santos |
author_facet |
Maria Altenfelder Santos Mark Drew Crosland Guimarães Ernani Tiaraju Santa Helena Cáritas Relva Basso Felipe Campos do Vale Wania Maria do Espírito Santo Carvalho Ana Maroso Alves Gustavo Machado Rocha Francisco de Assis Acurcio Maria das Graças Braga Ceccato Rogério Ruscitto do Prado Paulo Rossi Menezes Maria Ines Battistella Nemes |
author_role |
author |
author2 |
Mark Drew Crosland Guimarães Ernani Tiaraju Santa Helena Cáritas Relva Basso Felipe Campos do Vale Wania Maria do Espírito Santo Carvalho Ana Maroso Alves Gustavo Machado Rocha Francisco de Assis Acurcio Maria das Graças Braga Ceccato Rogério Ruscitto do Prado Paulo Rossi Menezes Maria Ines Battistella Nemes |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Maria Altenfelder Santos Mark Drew Crosland Guimarães Ernani Tiaraju Santa Helena Cáritas Relva Basso Felipe Campos do Vale Wania Maria do Espírito Santo Carvalho Ana Maroso Alves Gustavo Machado Rocha Francisco de Assis Acurcio Maria das Graças Braga Ceccato Rogério Ruscitto do Prado Paulo Rossi Menezes Maria Ines Battistella Nemes |
dc.subject.por.fl_str_mv |
Antiretroviral therapy Brazil Health services research HIV/AIDS National survey Nonadherence |
topic |
Antiretroviral therapy Brazil Health services research HIV/AIDS National survey Nonadherence Infecções por HIV Síndrome de imunodeficiência adquirida Brasil Pesquisa sobre serviços de saúde Adesão à medicação |
dc.subject.other.pt_BR.fl_str_mv |
Infecções por HIV Síndrome de imunodeficiência adquirida Brasil Pesquisa sobre serviços de saúde Adesão à medicação |
description |
Introduction: Patient adherence to antiretroviral therapy (ART) is critical for HIV treatment success. Monitoring rates of adherence in public HIV outpatient care facilities can improve outcomes in Brazil where ART is universally available. Methods: We conducted a national cross-sectional survey of ART adherence in 2010. Participants were selected using a multistage probability sample. First, HIV outpatient care facilities were stratified according to 7 Organizational Quality Classification (OQC) groups and regions. Second, 1 or 2 facilities were selected per region for each OQC group. Finally, patients were randomly selected at each facility. In a first component, patients were invited to answer to a web-based questionnaire (WebAd-Q), a validated self-reported tool that includes 3 questions on adherence to ART in the past 7 days (time scheduling—timing, drug regimen—medication, and pill counts—dose), herein named indicators of potential nonadherence (IPN). In addition, a subsample of participants were interviewed in order to obtain further data on sociodemographic and clinical characteristics (second component). The proportion of each IPN was estimated using weighted data to account for the sampling design with 95% confidence interval (CI) and descriptive analysis was carried out. Results: Fifty-five facilities were chosen and 2424 patients completed the WebAd-Q in the first component of the study, while 598 patients were interviewed for the second component. The weighted proportions of the IPN were 50.9%, 31.8%, and 19.5%, for timing, medication, and dose, respectively, while11.7% had all 3 indicators, varying from 5.9% in the Southeast and 21.9% in the Northeast regions. Overall, 61.1% of the patients had at least 1 IPN (95% CI: 58.5–63.7%). Patients reporting depression symptoms, illicit drug use and those who missed medical appointments had worse nonadherence outcomes. Conclusions: Overall, there was a high proportion of all indicators IPN and timing was the main component associated with low adherence. Although these indicators may not necessarily indicate individual nonadherence, they represent a worrisome scenario in the public Brazilian HIV care facilities. On a routine basis, these facilities can identify gaps in providing counseling and ART orientation to their clientele and develop innovative strategies to prevent nonadherence. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-05 |
dc.date.accessioned.fl_str_mv |
2023-11-10T15:28:05Z |
dc.date.available.fl_str_mv |
2023-11-10T15:28:05Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/1843/60777 |
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http://dx.doi.org/10.1097/MD.0000000000009015 |
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1536-5964 |
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http://dx.doi.org/10.1097/MD.0000000000009015 http://hdl.handle.net/1843/60777 |
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1536-5964 |
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eng |
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Medicine |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL |
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Universidade Federal de Minas Gerais |
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