Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa

Alcaide, María L.; Ramlagan, Shandir; Cook, Ryan; Peltzer, Karl; Weiss, Stephen M.; Sifunda, Sibusiso; Rodriguez, Violeta J.

doi:10.1007/s10461-017-1760-3

Cited by 34 publications

(43 citation statements)

References 11 publications

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“…In this study, DBS were used to quantify concentrations of EFV, with an overall good correlation (R 2 =0.904, p<0.001), albeit underestimation (53% ±9.5% lower) of plasma drug levels[47]. In another study, drug concentrations of parent tenofovir (TFV) from tenofovir disoproxil fumarate (TDF), lamivudine (3TC) and EFV were evaluated in a pregnant women cohort in rural South Africa, demonstrating an overestimation of adherence in self-report vs. DBS levels, but feasibility of DBS collection in this population[48]. The main limitation of these studies was the focus on parent drug concentrations in DBS, which are expected to also have short half-lives similar to their plasma counterparts, thus restricting their adherence evaluation to a qualitative yes/no information over a short period of time.…”

Section: New Pharmacologic Measures That Quantify Cumulative Drug Expmentioning

confidence: 99%

Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring

2018

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Antiretroviral drug concentrations in hair and dried blood spots are two novel pharmacological measures of cumulative drug adherence and exposure that have been recently evaluated in HIV treatment and pre-exposure prophylaxis. Real-time adherence monitoring using electronic devices has also proven highly informative, feasible, and well accepted, offering the possibility for an immediate intervention when non-adherence is detected. Both approaches offer considerable advantages over traditional adherence measures in predicting efficacy. New methods to objectively monitor adherence in real-time and over long time periods have been developed. Further research is required to better understand how these measures can optimize adherence and, ultimately, improve clinical outcomes in HIV treatment and prevention.

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Section: New Pharmacologic Measures That Quantify Cumulative Drug Expmentioning

confidence: 99%

Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring

2018

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“…Based on two previous studies, adherence was defined as detectable antiretroviral in dried blood spots [24], and the range of hair tenofovir concentration was 21 to 53 pg/mg when the subject took TDF 7 days/week (100% adherence) [36], we defined hair measure of optimal adherence as hair tenofovir concentration above LOQ, and suboptimal adherence as hair tenofovir concentration below LOQ.…”

Section: Hair Collection and Assaymentioning

confidence: 99%

“…Several studies have examined the concurrent validity of various self-reported measures with other devicebased measures [17] or biological measures (e.g., viral load, and antiretroviral concentration in various pharmacokinetic metrics) [10,19,[24][25][26]. While these studies provide important information regarding the validity of self-reported measures, data are limited in Chinese PLHIV and comparison of those self-reported measures with long-term biological measures of adherence.…”

Section: Introductionmentioning

confidence: 99%

Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China

Zhang

Qiao

et al. 2020

AIDS Res Ther

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Background: Antiretroviral adherence is essential to HIV treatment efficacy. Various self-reported measures are commonly used for assessing antiretroviral adherence. Limited data are available regarding the validity of those selfreported measures in comparison with long-term objective biomarkers of adherence measures such as hair measures. Methods: Self-reported adherence (frequency, percentage, and visual analog scale [VAS]) and hair tenofovir concentration were evaluated at a single time point from 268 people living with HIV in China. The responses to each of three self-reported measures were converted into percentage and then dichotomized as "optimal" (100%) vs. "suboptimal" (less than 100%) adherence. Two composite adherence scores (CAS) were created from the three self-reported measures: (1) an overall adherence was the average percentage of the three self-reported measures; (2) responses were termed optimal adherence if participants reporting optimal adherence in all three self-reported measures, while were termed suboptimal adherence. Hair tenofovir concentration was also dichotomized as "optimal" (above the limit of quantitation, 36 pg/mg) vs. "suboptimal" adherence (blow 36 pg/mg). Spearman correlation, kappa statistics, and logistic regression analysis were used to calculate the correlations, agreements, and predictions of self-reported measures with hair measure, respectively. Results: Overall adherence, but any of the three self-reported adherence, was correlated with hair tenofovir concentration (r = 0.13, p < 0.05). Self-reported optimal adherence in VAS and CAS measures were agreed with and predicted optimal adherence assessed by hair measure (Kappa = 0.107, adjusted OR = 1.88, 95% CI 1.03-3.45; Kappa = 0.109, adjusted OR = 1.80, 95% CI 1.02-3.18; all p < 0.05, respectively). Conclusion: VAS may be a good individual self-reported measure for antiretroviral adherence, and CAS may be a good composite self-reported measure for antiretroviral adherence.

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“…7 Unlike other measures of adherence, the Medication Adherence Rating Scale (MARS) describes an individual's medication adherence in three dimensions: medication adherence behavior, attitude toward taking medication, and negative side effects and attitudes to psychotropic medication. 7 Indeed, self-report measures of medication-taking behavior overestimate adherence when compared to objective measures, 8 and this is perhaps why it has been argued that aside from medication-taking behavior, self-report measures should also assess for barriers to adherence and beliefs. 9 The MARS has not been well utilized in sub-Saharan Africa: the authors only identified one previous report.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria

Owie

Olotu

James

2018

Trends Psychiatry Psychother.

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Introduction Assessing adherence in schizophrenia facilitates interventions that optimize outcomes. Adherence rating questionnaires are feasible and non-intrusive; however, no validated measure exists in sub-Saharan Africa. We aimed to assess the psychometric properties of the 10-item Medication Adherence Rating Scale (MARS). Methods This was a cross-sectional study of a cohort of patients with schizophrenia (n=230). A sociodemographic questionnaire, the Mini International Neuropsychiatric Interview (MINI), Positive and Negative Syndrome Scale (PANSS), Scale for the Unawareness of Mental Disorder (SUMD) and the MARS were all administered by an interviewer. Results The MARS demonstrated good reliability (Cronbach’s alpha: 0.76). The scale was reducible to a 3-factor construct (1 – medication adherence behavior, 2 – attitude to taking medications, and 3 – negative side effects and attitude to psychotropics), with significant though weak external validity in relation to psychopathology (p<0.001) and insight (p<0.001). The first factor showed good internal consistency (α=0.80), comprising six items that could serve as a reliable proxy measure of adherence in place of the MARS Conclusion The MARS demonstrated fair psychometric characteristics in assessing adherence in patients with schizophrenia in this cohort. The scale may be useful in the dimensional assessment of medication adherence for schizophrenia in sub-Saharan African settings.

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Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa

Cited by 34 publications

References 11 publications

Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring

Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring

Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China

Reliability and validity of the Medication Adherence Rating Scale in a cohort of patients with schizophrenia from Nigeria

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