Discrepancies between self-report and objective measures for stimulant drug use in HIV: Cognitive, medication adherence and psychological correlates

Abstract

While it has long been recognized that self-reported drug use may be at variance with objectively obtained evidence such as urine toxicology assays, few studies have explored the behavioral correlates of such discrepancies. Here we compared self-reported and objective measures of stimulant drug use for 162 HIV infected individuals and identified a sub-group with discrepancies between data obtained via the two methods. Results showed poorer neurocognitive performance (attention, learning/memory) and lower medication adherence rates for the discrepant group as compared to those who either acknowledged their drug use or accurately denied recent stimulant use. Using the Millon Clinical Multiaxial Inventory-III, it was also found that those in the discrepant group were more hesitant to reveal psychopathology. Comparisons of self-reported and objectively measured medication adherence data are also discussed.

Concordance of Adherence Measurement Using Self-Reported Adherence Questionnaires and Medication Monitoring Devices

“…[12] SRQs such as these could be validated and used in other chronic conditions. [61,62] The 4-item Morisky scale was the second most commonly used SRQ in the literature. It was originally developed to measure adherence to hypertension treatment and demonstrated high concurrent and predictive validity with regard to blood pressure control.…”

Functional Consequences of HIV-Associated Neuropsychological Impairment

“…Unfortunately, for many patients self-report of adherence has been shown to have limited accuracy. In particular, self-report of adherence has been found to be most discrepant from objective measures (generally, overestimating adherence) for individuals with cognitive impairment and for those whose adherence has been relatively poor (Levine et al 2006a, b; Reinhard et al 2007). Likewise, self-report has been shown to overestimate adherence by approximately 10–20% for most patients reporting perfect or near-perfect adherence (Arnsten et al 2001; Levine et al 2006a, b).…”

Hair analysis and self-report of methamphetamine use by methamphetamine dependent individuals

“…Forensic scientists commonly encounter the problems and doubts in application of hair testing and data interpretations. There have been many studies about relationship between drug histories and drug concentration in hair related to cocaine and heroine [4][5][6][7][8][9][10]. These studies reported either a strong or a weak association between drug dose and the hair analysis.…”