An Analysis of Electronically Monitored Adherence to Antiretroviral Medications

• Published in: AIDS and behavior Vol. 14; no. 4; pp. 755 - 768
• Main Authors: Knafl, George J., Bova, Carol A., Fennie, Kristopher P., O’Malley, Jean P., Dieckhaus, Kevin D., Williams, Ann B.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-08-2010; Springer Nature B.V
• Subjects: Acquired Immune Deficiency Syndrome; Antiretroviral agents; Antiretroviral drugs; Antiviral Agents - therapeutic use; Cluster Analysis; Drug Monitoring - instrumentation; Drug therapy; Elderly; Female; Health behavior; Health Psychology; HIV; HIV Infections - drug therapy; HIV Infections - virology; Human immunodeficiency virus; Humans; Infectious Diseases; Likelihood Functions; Male; Males; Medical Research; Medication Adherence - statistics & numerical data; Medications; Medicine; Medicine & Public Health; Middle Aged; Monitoring systems; Monitoring, Physiologic - methods; Original Paper; Participation; Poisson Distribution; Public Health; ROC Curve; Statistical methods; Viral Load; Whites; Young Adult; Electronic monitoring; Antiretroviral adherence; MEMS caps; Adaptive statistical methods
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-008-9512-z

Medication adherence studies increasingly collect data electronically, often using Medication Event Monitoring System (MEMS) caps. Analyses typically focus on summary adherence measures, although more complete analyses are possible using adaptive statistical methods. These methods were used to describe individual-subject adherence patterns for MEMS data from a clinical trial. Subjects were adaptively clustered into groups with similar adherence patterns and clusters were compared on a variety of subject characteristics. There were seven different adherence clusters: consistently high, consistently moderately high, consistently moderate, consistently moderately low, consistently low, deteriorating starting early, and deteriorating late. Compared to other subjects, subjects with consistently high and consistently moderately high adherence were more likely to be male, White, and older and to maintain during study participation a CD4 cell count over 500 and an HIV viral load of at most 400 copies/ml. These results demonstrate the effectiveness of adaptive methods for comprehensive analysis of MEMS data.