The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy

Abstract

The Center for Adherence Support Evaluation (CASE) Adherence Index, a simple composite measure of self-reported antiretroviral therapy (ART) adherence, was compared to a standard threeday self-reported adherence measure among participants in a longitudinal, prospective cross-site evaluation of 12 adherence programs throughout the United States. The CASE Adherence Index, consisting of three unique adherence questions developed for the cross-site study, along with a threeday adherence self-report were administered by interviews every three months over a one-year period. Data from the three cross-site adherence questions (individually and in combination) were compared to three-day self-report data and HIV RNA and CD4 outcomes in cross-sectional analyses. The CASE Adherence Index correlated strongly with the three-day self-reported adherence data (p < 0.001) and was more strongly associated with HIV outcomes, including a 1-log decline in HIV RNA level (maximum OR = 2.34; p < 0.05), HIV RNA<400 copies/ml (maximum OR = 2.33; p < 0.05) and performed as well as the three-day self-report when predicting CD4 count status. Participants with a CASE Index score >10 achieved a 98 cell mean increase in CD4 count over 12 months, compared to a 41 cell increase for those with scores ≤10 (p < 0.05). The CASE Adherence Index is an easy to

Development of an algorithm for determination of the likelihood of virological failure in HIV-positive adults receiving antiretroviral therapy in decentralized care

“…All patients enrolled in HIV care in Ethiopia receive adherence counselling at least twice before starting ART and adherence assessments are made at all clinical visits after ART initiation [21]. For study purposes, medication adherence was estimated using a three-question panel on: punctuality of daily tablet intake, number of missed doses weekly, and duration since last missed dose [24]. Treatment interruption of ART since last visit (for any reason and at least one day’s duration) was also recorded.…”

Factors Associated with Retention and Viral Suppression Among a Cohort of HIV+ Women of Color

“…Baseline medication adherence was self-reported and assessed using the Case Adherence Index (CAI), 32 which…”

A pilot study of a smoking cessation intervention for women living with HIV: study protocol

“…45 Compared with gas chromatography, the NicAlert had a specificity of 95% (95% confidence interval [CI; 89%, 100%]), sensitivity of 93% (95% CI [85%, 100%]), positive predictive value of 95% (95% CI [89%, 100%]), and a negative predictive value of 93% (95% CI [86%, 100%]). 46 At baseline, the following information will be obtained as part of demographic characteristics: race, ethnicity, age, marital status, employment, and years of education. Information on year of HIV diagnosis, current CD4 cell count, and viral load count will be obtained from selfreport.…”

“…Key study variables will be assessed using the following measures: HAART adherence, HIV-related sigma, Fagerström Test for Nicotine Dependence, Self-efficacy in Resisting Smoking Temptation, Center for Epidemiologic Studies-Depression Scale, Generalized Anxiety Disorder 7-item scale, and General Client Satisfaction Questionnaire. [46][47][48][49][50][51][52][53] These measures were selected to examine whether they would moderate or mediate the effect of the smoking cessation intervention. For example, the stigma measure assesses the degree of personalized (or self) stigma, HIV disclosure concerns, negative self-image, and concern with public attitudes toward people with HIV, which may be related to health promotion and wellness efforts, such as smoking cessation.…”