Adherence to Antiretroviral Treatment and Correlation with Risk of Hospitalization among Commercially Insured HIV Patients in the United States 英文参考文献.docVIP

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Adherence to Antiretroviral Treatment and Correlation with Risk of Hospitalization among Commercially Insured HIV Patients in the United States 英文参考文献.doc

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Adherence to Antiretroviral Treatment and Correlation with Risk of Hospitalization among Commercially Insured HIV Patients in the United States 英文参考文献

AdherencetoAntiretroviralTreatmentandCorrelation withRiskofHospitalizationamongCommerciallyInsured HIVPatientsintheUnitedStates PaulE.Sax1,JulianaL.Meyers2*,MichaelMugavero3,KeithL.Davis2 1Brigham and Women’s Hospital, Boston, Massachusetts, United States of America, 2RTI Health Solutions, Research Triangle Park, North Carolina, United States of America,3UniversityofAlabama,Birmingham,Alabama,UnitedStatesofAmerica Abstract Purpose: A lower daily pill burden may improve adherence to antiretroviral treatment (ART) and clinical outcomes in patientswithhumanimmunodeficiencyvirus(HIV).Thisstudyassesseddifferencesinadherenceusingthenumberofpills takenperday,andevaluatedhowadherencecorrelatedwithhospitalization. Methodology:CommerciallyinsuredpatientsintheLifeLinkdatabasewithanHIVdiagnosis(InternationalClassificationof Diseases,9thRevision,ClinicalModificationcode042.xx)between6/1/2006and12/31/2008andreceiptofacompleteART regimenwereselectedforinclusion.PatientsweregroupedaccordingtotheirdailypillcountandremainedonARTforat least60days.Outcomesincludedadherenceandratesofhospitalization.Adherencewasmeasuredastheproportionof daysbetweenthestartandendoftheregimeninwhichthepatientmaintainedsupplyofallinitiatedARTcomponents. Logistic regressions assessed the relationship between pills per day, adherence, and hospitalization, controlling for demographics,comorbidities,andART-na?¨ve(vs.experienced)status. Results:7,073patientsmetthestudyinclusioncriteria,and33.4%,5.8%,and60.8%receivedanARTregimencomprising one,two,orthreeormorepillsperday,respectively.Regressionanalysisshowedpatientsreceivingasinglepillperday weresignificantlymorelikelytoreacha95%adherencethresholdversuspatientsreceivingthreeormorepillsperday(odds ratio[OR]=1.59;P,0.001).Regardlessofthenumberofpillsreceivedperday,patientswereover40%lesslikelytohavea hospitalizationiftheywereadherenttotherapy(OR=0.57;P,0.001).Patientsreceivingasinglepillperdaywere24%less likelytohaveahospitalizationversuspatientsreceivingthreeorm