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Plasma Drug Level Validates Self-Reported Adherence but Predicts Limited Specificity for Nonadherence to Antiretroviral Therapy
Joint Authors
Baveewo, Steven
Musoke, David
Kayiwa, Joshua
Waako, Paul
Obua, Celestino
Ntale, Muhammad
Balikuddembe, Robert
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-03-06
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Pharmacy, Health & Medical Sciences
Pharmacology
Abstract EN
Introduction.
Adherence to antiretroviral therapy (ART) in low-income countries is mainly assessed by self-reported adherence (S-RA) without drug level determination.
Nonadherence is an important factor in the emergence of resistance to ART, presenting a need for drug level determination.
Objective.
We set out to establish the relationship between plasma stavudine levels and S-RA and validate S-RA against the actual plasma drug concentrations.
Methods.
A cross-sectional investigation involving 234 patients in Uganda.
Stavudine plasma levels were determined using high-performance liquid chromatography.
We compared categories of plasma levels of stavudine with S-RA using multivariable logistic regression models.
Results.
Overall, 194/234 patients had S-RA ≥ 95% (good adherence) and 166/234 had stavudine plasma concentrations ≥ 36 nmol/L (therapeuticconcentration).
Patients with good S-RA were eight times more likely to have stavudine levels within therapeutic concentration (Adjusted Odds Ratio: 7.7, 95% Confidence Interval: 3.5–7.0).
However, of the 194 patients with good S-RA, 21.7% had below therapeutic concentrations.
S-RA had high sensitivity for adherence (91.6%), but limited specificity for intrinsic poor adherence (38.2%).
Conclusions.
S-RA is a good tool for assessing adherence, but has low specificity in detecting nonadherence, which has implications for emergence of resistance.
American Psychological Association (APA)
Balikuddembe, Robert& Kayiwa, Joshua& Musoke, David& Ntale, Muhammad& Baveewo, Steven& Waako, Paul…[et al.]. 2012. Plasma Drug Level Validates Self-Reported Adherence but Predicts Limited Specificity for Nonadherence to Antiretroviral Therapy. ISRN Pharmacology،Vol. 2012, no. 2012, pp.1-7.
https://search.emarefa.net/detail/BIM-459512
Modern Language Association (MLA)
Balikuddembe, Robert…[et al.]. Plasma Drug Level Validates Self-Reported Adherence but Predicts Limited Specificity for Nonadherence to Antiretroviral Therapy. ISRN Pharmacology No. 2012 (2012), pp.1-7.
https://search.emarefa.net/detail/BIM-459512
American Medical Association (AMA)
Balikuddembe, Robert& Kayiwa, Joshua& Musoke, David& Ntale, Muhammad& Baveewo, Steven& Waako, Paul…[et al.]. Plasma Drug Level Validates Self-Reported Adherence but Predicts Limited Specificity for Nonadherence to Antiretroviral Therapy. ISRN Pharmacology. 2012. Vol. 2012, no. 2012, pp.1-7.
https://search.emarefa.net/detail/BIM-459512
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-459512