Abstract
The Patient Medication Adherence Questionnaire Version 1.0 (PMAQ-V1.0) is a patient-reported adherence instrument to assess medication-taking behaviors and identify barriers to adherence with antiretroviral therapy. To assess the correlation between adherence and virologic outcome, the PMAQ-V1.0 was administered to 194 antiretroviral-experienced adults with HIV infection enrolled in a 16-week evaluation of protease inhibitor-containing regimens featuring a lamivudine/ zidovudine combination tablet. At baseline, plasma HIV-1 RNA levels were less than 10,000 copies/mL and CD4+-cell counts were equal to or greater than 300 x 106/L; patients had been receiving a conventional regimen of lamivudine + zidovudine (separately) plus a protease inhibitor for at least 10 weeks immediately prior to the study. Forty-eight percent of patients who reported missing at least one dose of a nucleoside reverse-transcriptase inhibitor (NRTI) during the study had detectable plasma HIV-1 RNA, compared with 26% of patients who reported no missed doses (P = .002). Patients who missed at least one dose of an NRTI or protease inhibitor were 2.5 times more likely to have quantifiable HIV-1 RNA than those who reported no missed doses. Patients who reported fewer barriers and more motivators to adherence had better virologic outcomes (P = .001). Several dimensions of the PMAQ-V1.0 did not function as well as hypothesized. In this study, self-reported adherence derived from the PMAQ-V1.0 predicted virologic outcomes, but further refinement of the dimensions appears warranted.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Hammer S, Squires K, Hughes M, et al. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less.N Engl J Med. 1997;337:725–733.
Gulick RM, Mellors JW, Havlir D, et al. Simultaneous vs sequential initiation of therapy with indinavir, zidovudine, and lamivudine for HIV-1 infection: 100-week follow-up.JAMA. 1998; 280:35–41.
Coplan P, Cook J, Carides G, Nguyen B, Testa M, the ACTG320 Study Team. Impact of indinavir with zidovudine and lamivudine on quality of life for HIV patients with ≤200 CD4 in ACTG 320. In: Abstracts of the 6th Conference on Retroviruses and Opportunistic Infections; January 31-February 4, 1999; Chicago, I11. Abstract 101.
Tseng AL-I. Compliance issues in the treatment of HIV infection.Am J Health Syst Pharm. 1998; 55:1817–1824.
Jimenez-Nacher I, Rodriguez-Rosado R, Anton P, Soriano V, Gonzalez-Lahoz J. Virological failure and adherence to antiretroviral therapy in HIV-infected patients. Presented at the 12th World AIDS Conference; June 28-July 3, 1998; Geneva, Switzerland. Abstract 32350.
McCarron B, Pithie C, Mathers L, et al. Adherence to anti-retroviral therapy in Glasgow HIV patients.AIDS. 1998;12(suppl 4):S62. Abstract P181.
Bangsberg D, Hecht F, Charlebois E, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population.AIDS. 2000;14:357–366.
Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.Ann Intern Med. 2000;133:21–30.
Wainberg MA, Friedland G. Public health implications of antiretroviral therapy and HIV drug resistance.JAMA. 1998;279:1977–1983.
Task Force for Compliance.Noncompliance With Medications: An Economic Tragedy With Important Implications for Health Care Reform. Baltimore, Md: Task Force for Compliance; April 1994.
Childress JK, Jhingran P, Scott-Lennox J, Tolson J. Development and initial evaluation of the Patient Medication Adherence Questionnaire (PMAQ). Presented at the 6th European Conference on Clinical Aspects and Treatment of HIV Infection; October 11–15, 1997; Hamburg, Germany. Abstract/Poster N-23.
Eron JJ Jr, Yetzer ES, Ruane PJ, et al. Efficacy, safety, and adherence with a twice-daily combination lamivudine/zidovudine tablet formulation, plus a protease inhibitor, in HIV infection [published correction appears inAIDS. 2000;14: 1295].AIDS. 2000;14:671–681.
Abellán J, Garrote M, Sainz-Maza M, et al. Triple therapy adherence in HIV positive patients.AIDS. 1998;12(suppl 4):S62. Abstract P183.
Knobel H, Carmona A, Grau S, Saballs P, Gimeno JL, Lopez Colmes JL. Strategies to optimize adherence to highly active antiretroviral treatment. Presented at the 12th World AIDS Conference; June 28-July 3, 1998; Geneva, Switzerland. Abstract 388/32322. 15. Chesney MA. New antiretroviral therapies: adherence challenges and strategies. Presented at the 12th World AIDS Conference; June 28-July 3, 1998; Geneva, Switzerland.
Wu A, Yu-Isenberg K, McGrath M, Jacobson D. Reliability, validity, and usefulness of touch-screen administration of QOL and adherence instruments in an outpatient clinic. In: Abstracts of the 6th Conference on Retroviruses and Opportunistic Infections; January 31-February 4, 1999; Chicago, I11. Abstract 99.
Kleeberger CA, Phair JP, Strathdee SA, Detels R, Kingsley L, Jacobson LP. Determinants of heterogeneous adherence to HIV-antiretroviral therapies in the multicenter AIDS cohort study.J Acquir Immune Defic Syndr. 2001;26:82–92.
Salmon-Ceron D, Deleuze J, Coste J, et al. Adherence to antiretroviral treatments with a protease inhibitor in HIV-infected patients.Ann Med Interne (Paris). 2000;151:297–302.
Murri R, Ammassari A, Gallicano K, et al. Patient-reported nonadherence to HAART is related to protease inhibitor levels.J Acquir Immune Defic Syndr. 2000;24:123–128.
Chesney MA, Ickovics JR, Chambers DB, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG.AIDS Care. 2000;12:255–266.
Berge J, Braun J, Becker SS, et al. Relationship between demographic and clinical disease characteristics and medication adherence among patients in CHORUS. In: Abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 24–27, 1998; San Diego, Calif. Abstract I-212.
Cheever L. Adherence: issues and strategies.Medscape HIV/AIDS: Annual Update 2000. Available at: http://hiv.medscape.com/Medscape/HIV/AnnualUpdate/2000/mha.update05.08.cheever/ mha05.cheev01.html. Accessed June 12, 2000.
Bartlett JA, DeMasi R, Quinn J, Moxham C, Rousseau F. Meta-analysis of the effectiveness of triple combination therapy in antiretroviral naïve HIV-1-infected adults. In: Abstracts of the 7th Conference on Retroviruses and Opportunistic Infections; January 30-February 2, 2000; San Francisco, Calif. Abstract/Poster 519.
Golin C, Liu H, Hays R, et al. Self-reported adherence to protease inhibitors substantially overestimates an objective measure. In: Abstracts of the 6th Conference on Retroviruses and Opportunistic Infections; January 31-February 4, 1999; Chicago, Ill. Abstract 95.
Author information
Authors and Affiliations
Additional information
When this manuscript was written, Drs. DeMasi and Graham were employed by Glaxo Wellcome Inc., Research Triangle Park, North Carolina, USA.
Rights and permissions
About this article
Cite this article
DeMasi, R.A., Graham, N.M., Tolson, J.M. et al. Correlation between self-reported adherence to highly active antiretroviral therapy (HAART) and virologic outcome. Adv Therapy 18, 163–173 (2001). https://doi.org/10.1007/BF02850110
Issue Date:
DOI: https://doi.org/10.1007/BF02850110