Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies
Identifieur interne : 000C21 ( Pmc/Checkpoint ); précédent : 000C20; suivant : 000C22Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies
Auteurs : Lawrence Mbuagbaw ; Bhairavi Sivaramalingam ; Tamara Navarro ; Nicholas Hobson ; Arun Keepanasseril ; Nancy J. Wilczynski ; R. Brian HaynesSource :
- AIDS Patient Care and STDs [ 1087-2914 ] ; 2015.
Abstract
We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged.
Url:
DOI: 10.1089/apc.2014.0308
PubMed: 25825938
PubMed Central: 4410452
Affiliations:
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<series><title level="j">AIDS Patient Care and STDs</title>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="publisher-id">apc</journal-id>
<journal-title-group><journal-title>AIDS Patient Care and STDs</journal-title>
</journal-title-group>
<issn pub-type="ppub">1087-2914</issn>
<issn pub-type="epub">1557-7449</issn>
<publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name>
<publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25825938</article-id>
<article-id pub-id-type="pmc">4410452</article-id>
<article-id pub-id-type="publisher-id">10.1089/apc.2014.0308</article-id>
<article-id pub-id-type="doi">10.1089/apc.2014.0308</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical and Epidemiologic Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Interventions for Enhancing Adherence to Antiretroviral Therapy (ART): A Systematic Review of High Quality Studies</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Mbuagbaw</surname>
<given-names>Lawrence</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1,</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2,</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sivaramalingam</surname>
<given-names>Bhairavi</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Navarro</surname>
<given-names>Tamara</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hobson</surname>
<given-names>Nicholas</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Keepanasseril</surname>
<given-names>Arun</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wilczynski</surname>
<given-names>Nancy J.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Haynes</surname>
<given-names>R. Brian</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<aff id="aff1"><label><sup>1</sup>
</label>
Department of Clinical Epidemiology and Biostatistics,<institution>McMaster University</institution>
, Hamilton, Ontario,<country>Canada</country>
.</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
Biostatistics Unit,<institution>Father Sean O'Sullivan Research Centre</institution>
, St Joseph's Healthcare–Hamilton, Ontario,<country>Canada</country>
.</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
Centre for Development of Best Practices in Health,<institution>Yaoundé Central Hospital</institution>
, Yaoundé,<country>Cameroon</country>
.</aff>
<aff id="aff4"><label><sup>4</sup>
</label>
Department of Population Medicine,<institution>University of Guelph</institution>
, Guelph, Ontario,<country>Canada</country>
.</aff>
<aff id="aff5"><label><sup>5</sup>
</label>
Departments of Clinical Epidemiology and Biostatistics, and Medicine,<institution>McMaster University</institution>
, Hamilton, Ontario,<country>Canada</country>
.</aff>
</contrib-group>
<contrib-group><contrib contrib-type="collab"><collab>the Patient Adherence Review (PAR) Team</collab>
</contrib>
</contrib-group>
<author-notes><corresp><addr-line>Address correspondence to:</addr-line>
<addr-line><italic>Dr. Lawrence Mbuagbaw</italic>
</addr-line>
<addr-line><italic>Department of Clinical Epidemiology and Biostatistics</italic>
</addr-line>
<institution><italic>McMaster University</italic>
</institution>
<addr-line><italic>Hamilton, Ontario</italic>
</addr-line>
<country>Canada</country>
<break></break>
<italic>E-mail:</italic>
<email xlink:href="mailto:mbuagblc@mcmaster.ca">mbuagblc@mcmaster.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>01</day>
<month>5</month>
<year>2015</year>
<pmc-comment>string-date: May 2015</pmc-comment>
</pub-date>
<volume>29</volume>
<issue>5</issue>
<fpage>248</fpage>
<lpage>266</lpage>
<permissions><copyright-statement>Copyright 2015, Mary Ann Liebert, Inc.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="apc.2014.0308.pdf"></self-uri>
<abstract><title>Abstract</title>
<p>We sought to review the effectiveness of interventions designed to improve adherence to antiretroviral therapy (ART) from studies included in a recent Cochrane review that reported a clinical and an adherence outcome, with at least 80% follow-up for 6 months or more. Data were extracted independently and in duplicate, with an adjudicator for disagreements. Risk of bias was assessed using the Cochrane Risk of Bias tool. Of 182 relevant studies in the Cochrane review, 49 were related to ART. Statistical pooling was not warranted due to heterogeneity in interventions, participants, treatments, adherence measures and outcomes. Many studies had high risk of bias in elements of design and outcome ascertainment. Only 10 studies improved both adherence and clinical outcomes. These used the following interventions: adherence counselling (two studies); a once-daily regimen (compared to twice daily); text messaging; web-based cognitive behavioral intervention; face-to-face multi-session intensive behavioral interventions (two studies); contingency management; modified directly observed therapy; and nurse-delivered home visits combined with telephone calls. Patient-related adherence interventions were the most frequently tested. Uniform adherence measures and higher quality studies of younger populations are encouraged.</p>
</abstract>
<counts><fig-count count="4"></fig-count>
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<affiliations><list></list>
<tree><noCountry><name sortKey="Haynes, R Brian" sort="Haynes, R Brian" uniqKey="Haynes R" first="R. Brian" last="Haynes">R. Brian Haynes</name>
<name sortKey="Hobson, Nicholas" sort="Hobson, Nicholas" uniqKey="Hobson N" first="Nicholas" last="Hobson">Nicholas Hobson</name>
<name sortKey="Keepanasseril, Arun" sort="Keepanasseril, Arun" uniqKey="Keepanasseril A" first="Arun" last="Keepanasseril">Arun Keepanasseril</name>
<name sortKey="Mbuagbaw, Lawrence" sort="Mbuagbaw, Lawrence" uniqKey="Mbuagbaw L" first="Lawrence" last="Mbuagbaw">Lawrence Mbuagbaw</name>
<name sortKey="Navarro, Tamara" sort="Navarro, Tamara" uniqKey="Navarro T" first="Tamara" last="Navarro">Tamara Navarro</name>
<name sortKey="Sivaramalingam, Bhairavi" sort="Sivaramalingam, Bhairavi" uniqKey="Sivaramalingam B" first="Bhairavi" last="Sivaramalingam">Bhairavi Sivaramalingam</name>
<name sortKey="Wilczynski, Nancy J" sort="Wilczynski, Nancy J" uniqKey="Wilczynski N" first="Nancy J." last="Wilczynski">Nancy J. Wilczynski</name>
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