2.50
Hdl Handle:
http://hdl.handle.net/10755/163423
Category:
Abstract
Type:
Presentation
Title:
Predictors of Adherence Trajectories in Persons with HIV Infection
Author(s):
Erlen, Judith A.; Sereika, Susan M.; Dunbar-Jacob, Jacqueline
Author Details:
Judith A. Erlen, PhD, RN, FAAN, Professor, University of Pittsburgh Health Promotion and Development, Pittsburgh, Pennsylvania, USA, email: jae001@pitt.edu; Susan M. Sereika, PhD; Jacqueline Dunbar-Jacob, PhD, RN, FAAN
Abstract:
Purpose: Assessing the dynamic nature of medication adherence over time and potential predictors of response trajectories has been understudied. Thus, the purposes of this study were to estimate response trajectories of medication adherence, and identify joint predictors of adherence trajectories in persons with HIV infection prescribed HAART. Theoretical Framework: Bandura's self-efficacy theory provided the framework for this study. Methods (Design, Sample, Setting, Measures, Analysis): The sample (n=116; 68% male; 54% white) included the 101 subjects randomized to the usual care/control arm of a larger clinical trial (R01 NR04749) examining the effect of a structured intervention on medication adherence, and the 100% adherers (n=15) followed separately. Medication adherence was assessed over 7 months at baseline, post-intervention, and post-maintenance using electronic event monitors with inserted events from diaries when subjects "pocket dosed". Predictor variables were included based on self-efficacy theory. Results: The models of response trajectory for adherence based on correct doses yielded two groups: 65% had a flat adherence trajectory of 87-90% and 35% had a nonlinear response trajectory dipping from 30% to 12% and rising to 20%. Adherence defined as days with correct intake yielded 3 groups: 6.4% had a flat trajectory of 96-98%; 58.2% had decreasing linear adherence rates from 66% to 54%; 35.4% had a nonlinear adherence trajectory of 14% to 4% to 8%. Multivariate predictors of response trajectories for correct doses yielded self-efficacy as a protective factor (p=.01) and disclosure (stigma) as a risk factor for nonadherence (p=.02). Only disclosure (p=.007) was a significant risk factor for days with correct intake. Conclusions and Implications: The use of EEMs and diaries may account for some of the increase in adherence trajectories over time. Interventions need to be developed and tested targeting self-efficacy and stigma in order to improve and sustain adherence in this population.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
18th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Cherry Hill, New Jersey
Description:
�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jersey
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePredictors of Adherence Trajectories in Persons with HIV Infectionen_GB
dc.contributor.authorErlen, Judith A.en_US
dc.contributor.authorSereika, Susan M.en_US
dc.contributor.authorDunbar-Jacob, Jacquelineen_US
dc.author.detailsJudith A. Erlen, PhD, RN, FAAN, Professor, University of Pittsburgh Health Promotion and Development, Pittsburgh, Pennsylvania, USA, email: jae001@pitt.edu; Susan M. Sereika, PhD; Jacqueline Dunbar-Jacob, PhD, RN, FAANen_US
dc.identifier.urihttp://hdl.handle.net/10755/163423-
dc.description.abstractPurpose: Assessing the dynamic nature of medication adherence over time and potential predictors of response trajectories has been understudied. Thus, the purposes of this study were to estimate response trajectories of medication adherence, and identify joint predictors of adherence trajectories in persons with HIV infection prescribed HAART. Theoretical Framework: Bandura's self-efficacy theory provided the framework for this study. Methods (Design, Sample, Setting, Measures, Analysis): The sample (n=116; 68% male; 54% white) included the 101 subjects randomized to the usual care/control arm of a larger clinical trial (R01 NR04749) examining the effect of a structured intervention on medication adherence, and the 100% adherers (n=15) followed separately. Medication adherence was assessed over 7 months at baseline, post-intervention, and post-maintenance using electronic event monitors with inserted events from diaries when subjects "pocket dosed". Predictor variables were included based on self-efficacy theory. Results: The models of response trajectory for adherence based on correct doses yielded two groups: 65% had a flat adherence trajectory of 87-90% and 35% had a nonlinear response trajectory dipping from 30% to 12% and rising to 20%. Adherence defined as days with correct intake yielded 3 groups: 6.4% had a flat trajectory of 96-98%; 58.2% had decreasing linear adherence rates from 66% to 54%; 35.4% had a nonlinear adherence trajectory of 14% to 4% to 8%. Multivariate predictors of response trajectories for correct doses yielded self-efficacy as a protective factor (p=.01) and disclosure (stigma) as a risk factor for nonadherence (p=.02). Only disclosure (p=.007) was a significant risk factor for days with correct intake. Conclusions and Implications: The use of EEMs and diaries may account for some of the increase in adherence trajectories over time. Interventions need to be developed and tested targeting self-efficacy and stigma in order to improve and sustain adherence in this population.en_GB
dc.date.available2011-10-27T11:07:19Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:07:19Z-
dc.conference.date2006en_US
dc.conference.name18th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationCherry Hill, New Jerseyen_US
dc.description�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jerseyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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