Manioc : Portail | resultats 1 - 18 pour la recherche: relationship between adherence and effectiveness

Éditeur(s) : HAL CCSD American Public Health Association
Résumé : International audience
BACKGROUND: It is well established that high adherence to HIV-infected patients on highly active antiretroviral treatment (HAART) is a major determinant of virological and immunologic success. Furthermore, psychosocial research has identified a wide range of adherence factors including patients' subjective beliefs about the effectiveness of HAART. Current statistical approaches, mainly based on the separate identification either of factors associated with treatment effectiveness or of those associated with adherence, fail to properly explore the true relationship between adherence and treatment effectiveness. Adherence behavior may be influenced not only by perceived benefits-which are usually the focus of related studies-but also by objective treatment benefits reflected in biological outcomes. METHODS: Our objective was to assess the bidirectional relationship between adherence and response to treatment among patients enrolled in the ANRS CO8 APROCO-COPILOTE study. We compared a conventional statistical approach based on the separate estimations of an adherence and an effectiveness equation to an econometric approach using a 2-equation simultaneous system based on the same 2 equations. RESULTS: Our results highlight a reciprocal relationship between adherence and treatment effectiveness. After controlling for endogeneity, adherence was positively associated with treatment effectiveness. Furthermore, CD4 count gain after baseline was found to have a positive significant effect on adherence at each observation period. This immunologic parameter was not significant when the adherence equation was estimated separately. In the 2-equation model, the covariances between disturbances of both equations were found to be significant, thus confirming the statistical appropriacy of studying adherence and treatment effectiveness jointly. CONCLUSIONS: Our results, which suggest that positive biological results arising as a result of high adherence levels, in turn reinforce continued adherence and strengthen the argument that patients who do not experience rapid improvement in their immunologic and clinical statuses after HAART initiation should be prioritized when developing adherence support interventions. Furthermore, they invalidate the hypothesis that HAART leads to "false reassurance" among HIV-infected patients.
ISSN: 0025-7079

hal-00875196
https://hal.archives-ouvertes.fr/hal-00875196
DOI : 10.1097/MLR.0b013e3182422f61
PUBMED : 22362167

| Plus

The eruption of Pelée : a summary and discussion of the phenomena and their sequels
Auteur(s) : Heilprin, Angelo (1853-1907)
Année de publication :

| Plus

Report on sugar-cane borers at Soledad, Cuba. [Suivi de] Dry-season studies of cane homoptera at Soledad, Cuba : with a list of the coccids of the district
Auteur(s) : Salt, George W. (1903-2003) Myers, John Golding (1897-1942)
Année de publication :

| Plus

Sketches of Hayti : from the expulsion of the French, to the death of Christophe
Auteur(s) : Harvey, William Woodis (1798-1864)
Année de publication :

| Plus