SidaSubSaharaV1, Main, Exploration, bibRecord, 002B32

Adherence to Antiretroviral Therapy in India: A Systematic Review and Meta-Analysis

Identifieur interne : 002B32 ( Main/Exploration ); précédent : 002B31; suivant : 002B33

Adherence to Antiretroviral Therapy in India: A Systematic Review and Meta-Analysis

Auteurs : Rahul Mhaskar [États-Unis] ; Vaibhav Alandikar [États-Unis] ; Patricia Emmanuel [États-Unis] ; Benjamin Djulbegovic [États-Unis] ; Sangita Patel [Inde] ; Atul Patel [Inde] ; Eknath Naik [États-Unis] ; Shyam Mohapatra [États-Unis] ; Ambuj Kumar [États-Unis]

Source :

Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine [ 0970-0218 ] ; 2013.

RBID : PMC:3714945

Abstract

Objective:

To assess the adherence to antiretroviral therapy (ART) in the human immunodeficiency virus (HIV)-infected population in India.

Design:

Systematic review and meta-analysis.

Materials and Methods:

The Medline and Cochrane library database were searched. Any prospective or retrospective study enrolling a minimum of 10 subjects with a primary objective of assessing ART adherence in the HIV population in India was included. Data were extracted on adherence definition, adherence estimates, study design, study population characteristics, recall period and assessment method. For metaanalysis, the pooled proportion was calculated as a back-transform of the weighted mean of the transformed proportions (calculated according to the Freeman-Tukey variant of the arcsine square root) using the random effects model.

Results:

There were seven cross-sectional studies and one retrospective study enrolling 1666 participants. Publication bias was significant (P = 0.003). Pooled results showed an ART adherence rate of 70% (95% confidence interval: 59–81%, I² = 96.3%). Sensitivity analyses based on study design, adherence assessment method and study region did not influence adherence estimates. Fifty percent (4/8) of the studies reported cost of medication as the most common obstacle for ART adherence. Twenty-five percent (2/8) reported lack of access to medication as the reason for non-adherence and 12% (1/8) cited adverse events as the most prevalent reason for non-adherence. The overall methodological quality of the included studies was poor.

Conclusion:

Pooled results show that overall ART adherence in India is below the required levels to have an optimal treatment effect. The quality of studies is poor and cannot be used to guide policies to improve ART adherence.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714945

DOI: 10.4103/0970-0218.112435
PubMed: 23878418
PubMed Central: 3714945

Affiliations:

Le document en format XML

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<author><name sortKey="Djulbegovic, Benjamin" sort="Djulbegovic, Benjamin" uniqKey="Djulbegovic B" first="Benjamin" last="Djulbegovic">Benjamin Djulbegovic</name>
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<country xml:lang="fr">États-Unis</country>
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<series><title level="j">Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine</title>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Objective:</title>
<p>To assess the adherence to antiretroviral therapy (ART) in the human immunodeficiency virus (HIV)-infected population in India.</p>
</sec>
<sec id="st2"><title>Design:</title>
<p>Systematic review and meta-analysis.</p>
</sec>
<sec id="st3"><title>Materials and Methods:</title>
<p>The Medline and Cochrane library database were searched. Any prospective or retrospective study enrolling a minimum of 10 subjects with a primary objective of assessing ART adherence in the HIV population in India was included. Data were extracted on adherence definition, adherence estimates, study design, study population characteristics, recall period and assessment method. For metaanalysis, the pooled proportion was calculated as a back-transform of the weighted mean of the transformed proportions (calculated according to the Freeman-Tukey variant of the arcsine square root) using the random effects model.</p>
</sec>
<sec id="st4"><title>Results:</title>
<p>There were seven cross-sectional studies and one retrospective study enrolling 1666 participants. Publication bias was significant (<italic>P</italic>
 = 0.003). Pooled results showed an ART adherence rate of 70% (95% confidence interval: 59–81%, I<sup>2</sup>
 = 96.3%). Sensitivity analyses based on study design, adherence assessment method and study region did not influence adherence estimates. Fifty percent (4/8) of the studies reported cost of medication as the most common obstacle for ART adherence. Twenty-five percent (2/8) reported lack of access to medication as the reason for non-adherence and 12% (1/8) cited adverse events as the most prevalent reason for non-adherence. The overall methodological quality of the included studies was poor.</p>
</sec>
<sec id="st5"><title>Conclusion:</title>
<p>Pooled results show that overall ART adherence in India is below the required levels to have an optimal treatment effect. The quality of studies is poor and cannot be used to guide policies to improve ART adherence.</p>
</sec>
</div>
</front>
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Adherence to Antiretroviral Therapy in India: A Systematic Review and Meta-Analysis

Adherence to Antiretroviral Therapy in India: A Systematic Review and Meta-Analysis

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