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Adherence to combination antiretroviral treatment and clinical outcomes in a Medicaid sample of older HIV-infected adults.

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Title: Adherence to combination antiretroviral treatment and clinical outcomes in a Medicaid sample of older HIV-infected adults.
Authors: Abara, Winston E. (AUTHOR), Adekeye, Oluwatoyosi A. (AUTHOR), Xu, Junjun (AUTHOR), Rust, George (AUTHOR)
Source: AIDS Care. Apr2017, Vol. 29 Issue 4, p441-448. 8p.
Subjects: Combination drug therapy, Confidence intervals, Drugs, HIV infections, Hospital admission & discharge, Longitudinal method, Medicaid, Multivariate analysis, Patient compliance, Patients, Race, Regression analysis, Comorbidity, Antiretroviral agents, Retrospective studies, Descriptive statistics, Odds ratio, Middle age
Geographic Terms: United States
Abstract: The adherence threshold for combination antiretroviral therapy (cART) has historically been set at 95% or greater. We examined whether different levels of cART adherence (≥95% [optimal adherence], 90–94%, 80–89%, and <80%) were associated with different clinical outcomes (emergency department visits [ED visits] and duration of hospital admission) in a sample of older (50–64 years) persons living with HIV (PLWH). Medicaid data from 29 US states (n = 5177) were used for this study. cART adherence was measured and data regarding relevant covariates, such as race, sex, age, urbanicity, and comorbidity were obtained. Descriptive statistics were conducted to characterize study participants. We conducted univariate and multivariable regression analyses to evaluate the association between cART adherence and ED visits and duration of hospital admission while adjusting for covariates (race, sex, age, urbanicity, and comorbidity). Approximately 32% of all participants (n = 5177) reported optimal cART adherence (≥95%). After adjusting for covariates, only participants who reported <80% adherence were more likely to have an ED visit (adjusted odds ratio = 1.34, 95% CI = 1.08–1.48,p < .0001) and a longer duration of hospital admission (regression coefficient = 1.24, 95% CI = 0.53–1.96,p = .0007) when compared to participants who reported ≥95% adherence. There were no significant differences in likelihood of having an ED visit and longer duration of hospital admission between participants who reported ≥95% adherence and participants who reported 90–94% adherence and 80–89% adherence. Significant differences by covariates were observed. Adverse clinical outcomes were associated with low cART adherence (<80%) among older PLWH, though they did not differ between optimal and moderate cART adherence (90–94% and 80–89%). Although optimal cART adherence is an important goal, clinical outcomes in older PLWH may not differ between moderate and optimal cART adherence. [ABSTRACT FROM PUBLISHER]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Adherence to combination antiretroviral treatment and clinical outcomes in a Medicaid sample of older HIV-infected adults.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Abara%2C+Winston+E%2E%22&quot;&gt;Abara, Winston E.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Adekeye%2C+Oluwatoyosi+A%2E%22&quot;&gt;Adekeye, Oluwatoyosi A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Xu%2C+Junjun%22&quot;&gt;Xu, Junjun&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rust%2C+George%22&quot;&gt;Rust, George&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Apr2017, Vol. 29 Issue 4, p441-448. 8p.
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– Name: Abstract
  Label: Abstract
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  Data: The adherence threshold for combination antiretroviral therapy (cART) has historically been set at 95% or greater. We examined whether different levels of cART adherence (≥95% [optimal adherence], 90–94%, 80–89%, and &lt;80%) were associated with different clinical outcomes (emergency department visits [ED visits] and duration of hospital admission) in a sample of older (50–64 years) persons living with HIV (PLWH). Medicaid data from 29 US states (n = 5177) were used for this study. cART adherence was measured and data regarding relevant covariates, such as race, sex, age, urbanicity, and comorbidity were obtained. Descriptive statistics were conducted to characterize study participants. We conducted univariate and multivariable regression analyses to evaluate the association between cART adherence and ED visits and duration of hospital admission while adjusting for covariates (race, sex, age, urbanicity, and comorbidity). Approximately 32% of all participants (n = 5177) reported optimal cART adherence (≥95%). After adjusting for covariates, only participants who reported &lt;80% adherence were more likely to have an ED visit (adjusted odds ratio = 1.34, 95% CI = 1.08–1.48,p &lt; .0001) and a longer duration of hospital admission (regression coefficient = 1.24, 95% CI = 0.53–1.96,p = .0007) when compared to participants who reported ≥95% adherence. There were no significant differences in likelihood of having an ED visit and longer duration of hospital admission between participants who reported ≥95% adherence and participants who reported 90–94% adherence and 80–89% adherence. Significant differences by covariates were observed. Adverse clinical outcomes were associated with low cART adherence (&lt;80%) among older PLWH, though they did not differ between optimal and moderate cART adherence (90–94% and 80–89%). Although optimal cART adherence is an important goal, clinical outcomes in older PLWH may not differ between moderate and optimal cART adherence. [ABSTRACT FROM PUBLISHER]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=121123492
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2016.1257774
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 441
    Subjects:
      – SubjectFull: Combination drug therapy
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Drugs
        Type: general
      – SubjectFull: HIV infections
        Type: general
      – SubjectFull: Hospital admission & discharge
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Medicaid
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Race
        Type: general
      – SubjectFull: Regression analysis
        Type: general
      – SubjectFull: Comorbidity
        Type: general
      – SubjectFull: Antiretroviral agents
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Middle age
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Adherence to combination antiretroviral treatment and clinical outcomes in a Medicaid sample of older HIV-infected adults.
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            NameFull: Abara, Winston E.
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            NameFull: Adekeye, Oluwatoyosi A.
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            NameFull: Xu, Junjun
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            – D: 01
              M: 04
              Text: Apr2017
              Type: published
              Y: 2017
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              Value: 29
            – Type: issue
              Value: 4
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            – TitleFull: AIDS Care
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