The Scale of Self-Efficacy Expectations of Adherence to Antiretroviral Treatment: A Tool for Identifying Risk for Non-Adherence to Treatment for HIV

PLoS One

José Carlos de Carvalho Leite¹  Luciana Barcellos Teixeira²  Carlos Wietzke Drachler³  Maria de Lourdes Drachler⁴ 

[1]Mestrado Profissional em Saúde e Desenvolvimento Humano, Centro Universitário La Salle, Av. Victor Barreto, 2288, CEP: 92010–000, Canoas, RS, Brazil

[2]Programa de Pós-Graduação em Saúde Coletiva, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Rua São Manoel 963, CEP: 90.620–110, Porto Alegre, RS, Brazil

[3]Rede Governo Colaborativo em Saúde, Universidade Federal do Rio Grande do Sul, Av. João Pessoa 155, CEP: 90040–001, Porto Alegre, RS, Brazil

[4]Secretaria da Saúde do Estado do Rio Grande do Sul, Governo do Estado do Rio Grande do Sul, Av. Bento Gonçalves 3722, CEP: 90650–001, Porto Alegre, RS, Brazil

关键词: Antiretroviral therapy;    HIV;    Antiretrovirals;    Patients;    Brazil;    Drug therapy;    Viral load;    Outpatients;   

DOI  :  10.1371/journal.pone.0147443

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Background Identification of risk for non-adherence to treatment is a challenge for personalized care for people living with HIV. Standardized questionnaires of patients’ expectations of their capability to overcome obstacles for treatment adherence may be used as a pre-screening for risk identification. A scale of self-efficacy expectations of adherence to antiretroviral treatment (SEA-ART scale) was previously developed. This study assesses the scale validity in predicting non-adherence to ART in adults living with HIV. Methods and Findings A prospective cohort study applied a 21-item SEA-ART scale to 275 adults in ART treatment at an outpatient public service for HIV in Southern Brazil. ART medications taken were assessed at one-month follow-up; ART adherence was devised as an intake of 95% and more of the prescribed medication. A SEA-ART score was calculated by adding up the scores of all items. Multivariable logistic regression and the Area Under the Receiver-Operating-Characteristic Curve (AUROC) were applied to examine the ability of the SEA-ART score to predict non-adherence at follow-up. The SEA-ART score varied from 21 to 105; mean 93.9; median 103.0. Non-adherence was 30.3% (n = 81/267). The odds of non-adherence was 8% lower for each unit increase of the SEA-ART score; after adjustment for age, sex, formal education and time in treatment (OR = 0.92; 95%CI 0.90–0.95; LRT for linear trend, p = 0.002). The AUROC was 0.80 (95%CI 0.73–0.87; p<0.001). The SEA-ART optimal cut-off value was 101, providing a sensitivity of 76.5%, a specificity of 73.1%, a positive predictive value of 55.4% and a negative predictive value of 87.7%. There was no evidence of difference in sensitivity, and specificity among groups organized by age, gender, formal education and time in treatment. Conclusions The SEA-ART scale appears to have a good capacity to discriminate between adherents and non-adherents at one-month follow-up. Further studies should confirm these results in other populations.

【 授权许可】

CC BY