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Medication Possession Ratio Predicts Antiretroviral Regimens Persistence in Peru

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dc.contributor.author Salinas, Jorge L.
dc.contributor.author Alave, Jorge L.
dc.contributor.author Westfall, Andrew O.
dc.contributor.author Paz, Jorge
dc.contributor.author Moran, Fiorella
dc.contributor.author Carbajal-Gonzalez, Danny
dc.contributor.author Callacondo, David
dc.contributor.author Avalos, Odalie
dc.contributor.author Rodriguez, Martin
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Echevarria Zarate, Juan Ignacio
dc.contributor.author Willig, JamesH.
dc.date.accessioned 2022-01-04T20:31:49Z
dc.date.available 2022-01-04T20:31:49Z
dc.date.issued 2013
dc.identifier.uri https://hdl.handle.net/20.500.12866/10692
dc.description.abstract Objectives: In developing nations, the use of operational parameters (OPs) in the prediction of clinical care represents a missed opportunity to enhance the care process. We modeled the impact of multiple measurements of antiretroviral treatment (ART) adherence on antiretroviral treatment outcomes in Peru. Design And Methods: Retrospective cohort study including ART naïve, non-pregnant, adults initiating therapy at Hospital Nacional Cayetano Heredia, Lima-Peru (2006-2010). Three OPs were defined: 1) Medication possession ratio (MPR): days with antiretrovirals dispensed/days on first-line therapy; 2) Laboratory monitory constancy (LMC): proportion of 6 months intervals with ≥1 viral load or CD4 reported; 3) Clinic visit constancy (CVC): proportion of 6 months intervals with ≥1 clinic visit. Three multi-variable Cox proportional hazard (PH) models (one per OP) were fit for (1) time of first-line ART persistence and (2) time to second-line virologic failure. All models were adjusted for socio-demographic, clinical and laboratory variables. Results: 856 patients were included in first-line persistence analyses, median age was 35.6 years [29.4-42.9] and most were male (624; 73%). In multivariable PH models, MPR (per 10% increase HR=0.66; 95%CI=0.61-0.71) and LMC (per 10% increase 0.83; 0.71-0.96) were associated with prolonged time on first-line therapies. Among 79 individuals included in time to second-line virologic failure analyses, MPR was the only OP independently associated with prolonged time to second-line virologic failure (per 10% increase 0.88; 0.77-0.99). Conclusions: The capture and utilization of program level parameters such as MPR can provide valuable insight into patient-level treatment outcomes. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject major clinical study en_US
dc.subject medication compliance en_US
dc.subject patient compliance en_US
dc.subject Peru en_US
dc.subject Risk Factors en_US
dc.subject HIV Infections en_US
dc.subject Human immunodeficiency virus infection en_US
dc.subject antiretrovirus agent en_US
dc.subject cohort analysis en_US
dc.subject CD4 lymphocyte count en_US
dc.subject Retrospective Studies en_US
dc.subject retrospective study en_US
dc.subject article en_US
dc.subject HIV-1 en_US
dc.subject Antiretroviral Therapy, Highly Active en_US
dc.subject drug treatment failure en_US
dc.subject drug withdrawal en_US
dc.subject Treatment Failure en_US
dc.subject Delivery of Health Care en_US
dc.subject Outcome Assessment (Health Care) en_US
dc.subject clinic visit constancy en_US
dc.subject drug substitution en_US
dc.subject health care concepts en_US
dc.subject Human immunodeficiency virus proteinase inhibitor en_US
dc.subject laboratory monitoring constancy en_US
dc.subject medication possession ratio en_US
dc.subject nonnucleoside reverse transcriptase inhibitor en_US
dc.subject RNA directed DNA polymerase inhibitor en_US
dc.subject virus load en_US
dc.title Medication Possession Ratio Predicts Antiretroviral Regimens Persistence in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0076323
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.05
dc.relation.issn 1932-6203


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