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)

doi:10.1080/09540121.2018.1499859

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)

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

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 language	English
Pages (from-to)	1560-1566
Number of pages	7
Journal	AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume	30
Issue number	12
DOIs	https://doi.org/10.1080/09540121.2018.1499859
Publication status	Published - 2018 Dec 2

Bibliographical note

Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.

Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.

All Science Journal Classification (ASJC) codes

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/09540121.2018.1499859

Cite this

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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 Choi, {Jun Yong} and Shinichi Oka and Pacharee Kantipong and Sim, {Benedict L. H} and Ng, {Oon Tek} and Jeremy Ross and Matthew Law",

note = "Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Publisher Copyright: {\textcopyright} 2018, {\textcopyright} 2018 Informa UK Limited, trading as Taylor & Francis Group.",

year = "2018",

month = dec,

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doi = "10.1080/09540121.2018.1499859",

language = "English",

volume = "30",

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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, Jun Yong

AU - Oka, Shinichi

AU - Kantipong, Pacharee

AU - Sim, Benedict L. H

AU - Ng, Oon Tek

AU - Ross, Jeremy

AU - Law, Matthew

N1 - Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. Publisher Copyright: © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.

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

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

Access to Document

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