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首页> 外文期刊>AIDS care. >Which method of adherence measurement is most suitable for daily use to predict virological failure among immigrant and non-immigrant HIV-1 infected patients?
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Which method of adherence measurement is most suitable for daily use to predict virological failure among immigrant and non-immigrant HIV-1 infected patients?

机译：哪种依从性测量方法最适合日常用于预测移民和非移民HIV-1感染患者的病毒学失败？

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In industrialized countries, virological failure occurs more often among HIV-infected immigrant patients. Non-adherence is the most credible explanation. We compared adherence of immigrant patients with that of nonimmigrant patients in the Netherlands, and investigated which method of adherence measurement is most suitable for daily use to predict virological treatment failure: testing knowledge of the current regimen, a quantitative adherence interview, pharmacy prescription refill ratio (dispensed medication divided by prescribed medication, DM/PM), and plasma drug levels. Included were 61 immigrants and 81 non-immigrants. Virological failure did occur more often in immigrants than in non-immigrants (19.7% (12/61) versus 8.6% (7/81), p = 0.056), especially among previously naive patients (19.6% (11/56) versus 0% (0/54), p <0.01). There were no differences between both groups on any of the four adherence measures. Virological failure was associated with reporting stopping medication when not feeling well (OR = 12, 95%CI = 1.9-77.7, p = 0.02), and, among naive patients, also with a DM/PM < 0.85 (Odds Ratio = 5.1, 95% Confidence Interval = 1.2-22.3, p = 0.03). Although our study confirmed a much higher virological failure rate among immigrants, we were unable to identify clear differences in adherence between immigrants and non-immigrant patient, although virological failure was associated with stopping medication when not feeling well and a low DM/PM. Unstructured treatment interruptions are a likely explanation of the findings. Interventions should be aimed at preventing patients to stop medication. A DM/PM below 0.85 can be indicative for patients who did stop medication and are at risk for virological failure.
机译：在工业化国家，病毒学失败更多发生在感染了HIV的移民患者中。不遵守是最可靠的解释。我们比较了荷兰的移民患者和非移民患者的依从性，并调查了哪种依从性测量方法最适合日常使用以预测病毒治疗失败：测试当前方案的知识，定量依从性访谈，药房处方补充率（已分配的药物除以处方药物，DM / PM）和血浆药物水平。其中包括61名移民和81名非移民。病毒性感染的确比非移民更常见（19.7％（12/61）对8.6％（7/81），p = 0.056），尤其是在以前的天真的患者中（19.6％（11/56）对0） ％（0/54），p ＜0.01）。两组在四种依从性措施中的任何一项上都没有差异。病毒学失败与报告感觉不适时停止用药有关（OR = 12，95％CI = 1.9-77.7，p = 0.02），并且在天真的患者中，DM / PM <0.85（几率= 5.1， 95％置信区间= 1.2-22.3，p = 0.03）。尽管我们的研究证实了移民中较高的病毒学失败率，但我们无法确定移民与非移民患者之间依从性的明显差异，尽管病毒性失败与感觉不适和DM / PM低时停药有关。非结构化的治疗中断可能是该发现的解释。干预措施应旨在防止患者停止用药。 DM / PM低于0.85可能表明确实停止服药并且有病毒学失败风险的患者。

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