Multiple self-report measures of antiretroviral adherence correlated in Sierra Leone, but did they agree?. (December 2013)

• Record Type: Journal Article
• Authors: Kelly, J Daniel; Hubenthal, Erica A; Lurton, Gregoire; Empson, Susannah F; Barrie, M Bailor; Kargbo, Brima; Wagner, Glenn J; Giordano, Thomas P
• Is Part Of: International journal of STD & AIDS. Volume 24:Number 12(2013)
• Page Start: 931
• Page End: 937
• Publication Date: 2013-12
• Subjects: HIV/AIDS -- treatment -- antiretroviral therapy -- adherence -- self-report -- validation -- sub-Saharan Africa -- Sierra Leone; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462413487327
• Languages: English
• ISSNs: 0956-4624

Abstract

In resource-poor settings, studies validating multiple self-report measures of adherence are limited and do not include data from West Africa. We prospectively assessed the associations between multiple self-report measures of adherence in 58 patients receiving antiretroviral therapy. Self-report measures included a 30-day visual analog scale, 30-day qualitative single-item measure, Adult AIDS Clinical Trial Group 4-day recall, and 3-level categorical 7-day qualitative measure. Unannounced pill count was the objective measure. Spearman's rho correlation coefficients, Bland-Altman plots, and receiver operator curve analyses were performed. Median and mean adherence by pill count were 81.8% and 78.6%, respectively. All self-report measures had either intermediate or high correlation with the pill count, and the 7-day measure had the highest level of correlation with pill count ( r = 0.72). All self-report measures demonstrated good agreement when mean pill count adherence was greater than 90%. All but the 7-day measure posed challenges to patient understanding and administration of the measure. In this sample of participants that displayed largely suboptimal adherence, the 7-day measure was preferable, but all self-report measures demonstrated relatively good agreement with the objective criterion pill count measure and are adequate for clinical use in settings such as Sierra Leone.