Early suboptimal ART adherence was associated with missed clinical visits in HIV-infected patients in Asia

on behalf of the TREAT Asia HIV Observational Database (TAHOD)

Research output: Contribution to journalArticle

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Abstract

Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7%) having at least one missed visit. Patients with early suboptimal self-reported adherence <95% were more likely to have a missed visit compared to those with adherence ≥95% (OR = 2.55, 95% CI(1.81–3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95%CI(1.27–1.66)) and other modes of HIV exposure (OR = 1.48, 95%CI(1.27–1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95%CI(1.15–1.53) and other ART combinations (OR = 1.79, 95%CI(1.39–2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95%CI(1.06–1.52)). Patients aged >30 years (31–40 years OR = 0.81, 95%CI(0.73–0.89); 41–50 years OR = 0.73, 95%CI(0.64–0.83); and >50 years OR = 0.77, 95%CI(0.64–0.93)); female sex (OR = 0.81, 95%CI(0.72–0.90)); and being from upper middle (OR = 0.78, 95%CI(0.70–0.80)) or high-income countries (OR = 0.42, 95%CI(0.35–0.51)), were less likely to have missed visits. Almost 40% of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.

Original languageEnglish
Pages (from-to)1560-1566
Number of pages7
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume30
Issue number12
DOIs
Publication statusPublished - 2018 Dec 2

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HIV
Ambulatory Care
counseling
intervention strategy
Counseling
Therapeutics
logistics
determinants
income
regression
Secondary Prevention
Statistical Factor Analysis
Logistic Models

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

@article{247c1b83c67f4bd1ba13fcdee25d7a67,
title = "Early suboptimal ART adherence was associated with missed clinical visits in HIV-infected patients in Asia",
abstract = "Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7{\%}) having at least one missed visit. Patients with early suboptimal self-reported adherence <95{\%} were more likely to have a missed visit compared to those with adherence ≥95{\%} (OR = 2.55, 95{\%} CI(1.81–3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95{\%}CI(1.27–1.66)) and other modes of HIV exposure (OR = 1.48, 95{\%}CI(1.27–1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95{\%}CI(1.15–1.53) and other ART combinations (OR = 1.79, 95{\%}CI(1.39–2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95{\%}CI(1.06–1.52)). Patients aged >30 years (31–40 years OR = 0.81, 95{\%}CI(0.73–0.89); 41–50 years OR = 0.73, 95{\%}CI(0.64–0.83); and >50 years OR = 0.77, 95{\%}CI(0.64–0.93)); female sex (OR = 0.81, 95{\%}CI(0.72–0.90)); and being from upper middle (OR = 0.78, 95{\%}CI(0.70–0.80)) or high-income countries (OR = 0.42, 95{\%}CI(0.35–0.51)), were less likely to have missed visits. Almost 40{\%} of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.",
author = "{on behalf of the TREAT Asia HIV Observational Database (TAHOD)} and Awachana Jiamsakul and Kerr, {Stephen J.} and Sasisopin Kiertiburanakul and Iskandar Azwa and Fujie Zhang and Romanee Chaiwarith and Wingwai Wong and Ly, {Penh Sun} and Nagalingeswaran Kumarasamy and Rossana Ditangco and Sanjay Pujari and Evy Yunihastuti and Do, {Cuong Duy} and Merati, {Tuti Parwati} and Nguyen, {Kinh Van} and Lee, {Man Po} and JunYong Choi and Shinichi Oka and Pacharee Kantipong and Sim, {Benedict L. H} and Ng, {Oon Tek} and Jeremy Ross and Matthew Law",
year = "2018",
month = "12",
day = "2",
doi = "10.1080/09540121.2018.1499859",
language = "English",
volume = "30",
pages = "1560--1566",
journal = "AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV",
issn = "0954-0121",
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}

Early suboptimal ART adherence was associated with missed clinical visits in HIV-infected patients in Asia. / on behalf of the TREAT Asia HIV Observational Database (TAHOD).

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 30, No. 12, 02.12.2018, p. 1560-1566.

Research output: Contribution to journalArticle

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T1 - Early suboptimal ART adherence was associated with missed clinical visits in HIV-infected patients in Asia

AU - on behalf of the TREAT Asia HIV Observational Database (TAHOD)

AU - Jiamsakul, Awachana

AU - Kerr, Stephen J.

AU - Kiertiburanakul, Sasisopin

AU - Azwa, Iskandar

AU - Zhang, Fujie

AU - Chaiwarith, Romanee

AU - Wong, Wingwai

AU - Ly, Penh Sun

AU - Kumarasamy, Nagalingeswaran

AU - Ditangco, Rossana

AU - Pujari, Sanjay

AU - Yunihastuti, Evy

AU - Do, Cuong Duy

AU - Merati, Tuti Parwati

AU - Nguyen, Kinh Van

AU - Lee, Man Po

AU - Choi, JunYong

AU - Oka, Shinichi

AU - Kantipong, Pacharee

AU - Sim, Benedict L. H

AU - Ng, Oon Tek

AU - Ross, Jeremy

AU - Law, Matthew

PY - 2018/12/2

Y1 - 2018/12/2

N2 - Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7%) having at least one missed visit. Patients with early suboptimal self-reported adherence <95% were more likely to have a missed visit compared to those with adherence ≥95% (OR = 2.55, 95% CI(1.81–3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95%CI(1.27–1.66)) and other modes of HIV exposure (OR = 1.48, 95%CI(1.27–1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95%CI(1.15–1.53) and other ART combinations (OR = 1.79, 95%CI(1.39–2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95%CI(1.06–1.52)). Patients aged >30 years (31–40 years OR = 0.81, 95%CI(0.73–0.89); 41–50 years OR = 0.73, 95%CI(0.64–0.83); and >50 years OR = 0.77, 95%CI(0.64–0.93)); female sex (OR = 0.81, 95%CI(0.72–0.90)); and being from upper middle (OR = 0.78, 95%CI(0.70–0.80)) or high-income countries (OR = 0.42, 95%CI(0.35–0.51)), were less likely to have missed visits. Almost 40% of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.

AB - Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7%) having at least one missed visit. Patients with early suboptimal self-reported adherence <95% were more likely to have a missed visit compared to those with adherence ≥95% (OR = 2.55, 95% CI(1.81–3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95%CI(1.27–1.66)) and other modes of HIV exposure (OR = 1.48, 95%CI(1.27–1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95%CI(1.15–1.53) and other ART combinations (OR = 1.79, 95%CI(1.39–2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95%CI(1.06–1.52)). Patients aged >30 years (31–40 years OR = 0.81, 95%CI(0.73–0.89); 41–50 years OR = 0.73, 95%CI(0.64–0.83); and >50 years OR = 0.77, 95%CI(0.64–0.93)); female sex (OR = 0.81, 95%CI(0.72–0.90)); and being from upper middle (OR = 0.78, 95%CI(0.70–0.80)) or high-income countries (OR = 0.42, 95%CI(0.35–0.51)), were less likely to have missed visits. Almost 40% of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.

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