Therapeutic drug monitoring of indinavir and nelfinavir to assess adherence to therapy in human immunodeficiency virus-infected children

Rossum, Annemarie M. C. van; Bergshoeff, Alina S.; Fraaij, Pieter L. A.; Hugen, P.W.H.; Hartwig, Nico G.; Geelen, Sibyl P. M.; Wolfs, Tom F. W.; Weemaes, C.M.R.; Groot, Ronald de; Burger, David M.

doi:10.1097/00006454-200208000-00009

Cited by 34 publications

(16 citation statements)

References 21 publications

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“…Another possible reason for the variation is that study participants were on varying antiretroviral regimens, and adherence can differ according to medication as a result of variations in such factors as palatability or tolerability. 35 For example, in 1 study, full adherence varied from a low of 59% to a high of 100% depending on the regimen. 29 Differences in study methodology also may have contributed to the wide range of adherence estimates.…”

Section: Estimates Of Adherence According To Assessment Methodsmentioning

confidence: 98%

“…43,44 Studies have demonstrated better adherence with a twice-per-day (vs 3-times-per-day) nelfinavir regimen, shorter length of time since treatment initiation, and nelfinavir rather than indinavir but not with pill burden or drug toxicity. 18,29,35,36 Pontali 43 cited such factors as the availability and cost of the medications, accessibility of treatment, and health care providers' experience and relationship to the patient as health care system variables that are possibly associated with adherence. We found no studies that specifically evaluated the association between such variables and pediatric antiretroviral adherence.…”

Section: Factors Related To Adherencementioning

confidence: 99%

See 1 more Smart Citation

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Simoni

Montgomery

Martin³

et al. 2007

Pediatrics

197

166

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Although nonadherence to prescribed therapies is widespread, it is particularly problematic with highly active antiretroviral therapy for HIV infection. This review of >50 studies in the area of pediatric HIV infection revealed varying methods for assessing antiretroviral adherence with a wide range of estimates of adherence. Correlates of adherence could be grouped as those relating to the medication, the patient, and the caregiver/family, with many conflicting findings and a lack of theory guiding the research. Only 8 studies, mainly small feasibility or pilot investigations, evaluated highly active antiretroviral therapy adherence interventions in pediatric populations. We conclude with specific recommendations for assessment and clinical management of adherence and discuss directions for future research in this area. KeywordsHIV/AIDS; adherence; compliance; interventions; pediatric Adherence to therapy, or the extent to which a patient's behaviors coincide with medical advice mutually negotiated between the health professional and the patient, is a universal HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript challenge with all illnesses and in all age groups. 1 Each year in the United States, 500 000 physicians write 1.8 billion prescriptions involving 55 000 pharmacies. 2 However, many of these prescribed medications are never taken, with rates of nonadherence ranging from 15% to 93%. 3 Among persons with chronic illnesses, nonadherence is especially problematic, occurring in up to 82% of cases. [4][5][6] The effects of nonadherence range from individual disability (eg, unrelieved pain) to global threat (eg, development of treatment-resistant bacteria or viruses). The yearly monetary costs of nonadherence exceed $100 billion. 7Adherence is particularly critical with highly active antiretroviral therapy (HAART) in the treatment of pediatric HIV infection. The data on HAART for pediatric HIV infection, although scarcer than for adults, suggest that medication adherence is a strong predictor of therapeutic impact. 8,9 For example, Wiener et al 10 observed that among children with an HIV-1 RNA viral load (VL) < 10 000, 75% had taken 100% of their medication doses in the previous week, whereas among those with a VL of ≥10 000, only 36% reported taking all of their medication.Despite the benefits of HAART in treating pediatric HIV infection [11][12][13][14][15] and the adverse consequences of nonadherence, adherence is reportedly suboptimal among children. [16][17][18][19][20] It is likely thwarted by multiple barriers 21,22 and complicated because, unlike with many other chronic illnesses, most children who are born with HIV in the United States are ethnic/racial minorities who live in chronic poverty with limited resources and face discrimination, family disruption, substance abuse, and the stressors of life in the inner city. 23 In addition, stigma is greater for HIV/AIDS than other chronic illnesses, which often leads caregivers to conceal the child's diagnosis a...

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Section: Estimates Of Adherence According To Assessment Methodsmentioning

confidence: 98%

Section: Factors Related To Adherencementioning

confidence: 99%

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Simoni

Montgomery

Martin³

et al. 2007

Pediatrics

197

166

View full text Add to dashboard Cite

show abstract

“…In adult patients, the mean ART adherence has been reported to be between 80% and 91%, and multiple adherence barriers have been identified 6 7. In paediatric HIV-infected patients, ART adherence has been reported to be lower (58%),8 9 due to the combination of patient or caregiver factors including age and maturity-related tolerability and parental involvement 10 11 12 13. Several population-specific ART adherence barriers have been established in paediatric HIV such as dependence on a caregiver, poor palatability (particularly of liquid preparations), large pill size and pill swallowing capacity relative to the child’s developmental stage 9 11…”

mentioning

confidence: 99%

Evaluating adherence to medication in children and adolescents with HIV

Khan

Song

Williams

et al. 2009

Archives of Disease in Childhood

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“…Home visits can play an important role, and in some cases, suspected nonadherence is confirmed only when dramatic clinical responses to antiretroviral therapy occur during hospitalizations or in other supervised settings [72]. Preliminary studies suggest that monitoring plasma concentrations of protease inhibitors, or therapeutic drug monitoring, may be a useful method to identify nonadherence, but this approach remains investigational [73].…”

Section: Adherence Assessment and Monitoringmentioning

confidence: 99%

Guidelines for the use of antiretroviral agents in pediatric HIV infection

Oleske¹,

Scott²

2008

PsycEXTRA Dataset

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Therapeutic drug monitoring of indinavir and nelfinavir to assess adherence to therapy in human immunodeficiency virus-infected children

Abstract: Calculation of adherence rates using the lower limit of CORALs of indinavir or nelfinavir in children may be a useful measurement for the assessment of nonadherence to antiretroviral therapy in children.

Cited by 34 publications

References 21 publications

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Evaluating adherence to medication in children and adolescents with HIV

Guidelines for the use of antiretroviral agents in pediatric HIV infection

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