Patient Retention and Adherence to Antiretrovirals in a Large Antiretroviral Therapy Program in Nigeria: A Longitudinal Analysis for Risk Factors
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{"title"=>"Patient retention and adherence to antiretrovirals in a large antiretroviral therapy program in Nigeria: A longitudinal analysis for risk factors", "type"=>"journal", "authors"=>[{"first_name"=>"Man", "last_name"=>"Charurat", "scopus_author_id"=>"6602751035"}, {"first_name"=>"Modupe", "last_name"=>"Oyegunle", "scopus_author_id"=>"36458930300"}, {"first_name"=>"Renata", "last_name"=>"Benjamin", "scopus_author_id"=>"36458233500"}, {"first_name"=>"Abdulrazaq", "last_name"=>"Habib", "scopus_author_id"=>"35569541400"}, {"first_name"=>"Emeka", "last_name"=>"Eze", "scopus_author_id"=>"23974368500"}, {"first_name"=>"Prince", "last_name"=>"Ele", "scopus_author_id"=>"6505862240"}, {"first_name"=>"Iquo", "last_name"=>"Ibanga", "scopus_author_id"=>"6507763076"}, {"first_name"=>"Samuel", "last_name"=>"Ajayi", "scopus_author_id"=>"8637281800"}, {"first_name"=>"Maria", "last_name"=>"Eng", "scopus_author_id"=>"35113036600"}, {"first_name"=>"Prosanta", "last_name"=>"Mondal", "scopus_author_id"=>"14625412300"}, {"first_name"=>"Usman", "last_name"=>"Gebi", "scopus_author_id"=>"6504325686"}, {"first_name"=>"Emilia", "last_name"=>"Iwu", "scopus_author_id"=>"36458354900"}, {"first_name"=>"Mary Ann", "last_name"=>"Etiebet", "scopus_author_id"=>"6506905290"}, {"first_name"=>"Alash'le", "last_name"=>"Abimiku", "scopus_author_id"=>"6602350343"}, {"first_name"=>"Patrick", "last_name"=>"Dakum", "scopus_author_id"=>"35331903800"}, {"first_name"=>"John", "last_name"=>"Farley", "scopus_author_id"=>"7202145517"}, {"first_name"=>"William", "last_name"=>"Blattner", "scopus_author_id"=>"7102371375"}], "year"=>2010, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"359515519", "sgr"=>"77956500624", "issn"=>"19326203", "pmid"=>"20485670", "scopus"=>"2-s2.0-77956500624", "doi"=>"10.1371/journal.pone.0010584", "isbn"=>"1932-6203"}, "id"=>"e629a834-594d-3ecf-86f4-9bf1e5d59fb9", "abstract"=>"BACKGROUND: Substantial resources and patient commitment are required to successfully scale-up antiretroviral therapy (ART) and provide appropriate HIV management in resource-limited settings. We used pharmacy refill records to evaluate risk factors for loss to follow-up (LTFU) and non-adherence to ART in a large treatment cohort in Nigeria. METHODS AND FINDINGS: We reviewed clinic records of adult patients initiating ART between March 2005 and July 2006 at five health facilities. Patients were classified as LTFU if they did not return >60 days from their expected visit. Pharmacy refill rates were calculated and used to assess non-adherence. We identified risk factors associated with LTFU and non-adherence using Cox and Generalized Estimating Equation (GEE) regressions, respectively. Of 5,760 patients initiating ART, 26% were LTFU. Female gender (p < 0.001), post-secondary education (p = 0.03), and initiating treatment with zidovudine-containing (p = 0.004) or tenofovir-containing (p = 0.05) regimens were associated with decreased risk of LTFU, while patients with only primary education (p = 0.02) and those with baseline CD4 counts (cell/ml(3)) >350 and <100 were at a higher risk of LTFU compared to patients with baseline CD4 counts of 100-200. The adjusted GEE analysis showed that patients aged <35 years (p = 0.005), who traveled for >2 hours to the clinic (p = 0.03), had total ART duration of >6 months (p<0.001), and CD4 counts >200 at ART initiation were at a higher risk of non-adherence. Patients who disclosed their HIV status to spouse/family (p = 0.01) and were treated with tenofovir-containing regimens (p < or = 0.001) were more likely to be adherent. CONCLUSIONS: These findings formed the basis for implementing multiple pre-treatment visit preparation that promote disclosure and active community outreaching to support retention and adherence. Expansion of treatment access points of care to communities to diminish travel time may have a positive impact on adherence.", "link"=>"http://www.mendeley.com/research/patient-retention-adherence-antiretrovirals-large-antiretroviral-therapy-program-nigeria-longitudina", "reader_count"=>162, "reader_count_by_academic_status"=>{"Unspecified"=>7, "Professor > Associate Professor"=>5, "Librarian"=>4, "Researcher"=>34, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>28, "Student > Postgraduate"=>19, "Student > Master"=>40, "Other"=>8, "Student > Bachelor"=>5, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>7, "Professor > Associate Professor"=>5, "Librarian"=>4, "Researcher"=>34, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>28, "Student > Postgraduate"=>19, "Student > Master"=>40, "Other"=>8, "Student > Bachelor"=>5, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Agricultural and Biological Sciences"=>3, "Business, Management and Accounting"=>4, "Veterinary Science and Veterinary Medicine"=>1, "Computer Science"=>3, "Economics, Econometrics and Finance"=>2, "Environmental Science"=>1, "Nursing and Health Professions"=>10, "Mathematics"=>2, "Medicine and Dentistry"=>100, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Psychology"=>5, "Social Sciences"=>17, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>100}, "Social Sciences"=>{"Social Sciences"=>17}, "Psychology"=>{"Psychology"=>5}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>10}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>10}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Mozambique"=>1, "Iran"=>1, "United States"=>2, "South Africa"=>3, "Ghana"=>1, "Nigeria"=>2, "Kenya"=>1, "Switzerland"=>3, "Ethiopia"=>1}, "group_count"=>20}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/850209"], "description"=>"a<p>Totals do not always sum to 4,529 due to missing data;</p>b<p>A total of 3,136 subjects included in the adjusted model; OR, odds ratio; CI, confidence interval.</p>", "links"=>[], "tags"=>["pharmacy", "refill", "nigerian", "patients"], "article_id"=>520642, "categories"=>["Medicine", "Cancer"], "users"=>["Man Charurat", "Modupe Oyegunle", "Renata Benjamin", "Abdulrazaq Habib", "Emeka Eze", "Prince Ele", "Iquo Ibanga", "Samuel Ajayi", "Maria Eng", "Prosanta Mondal", "Usman Gebi", "Emilia Iwu", "Mary-Ann Etiebet", "Alash'le Abimiku", "Patrick Dakum", "John Farley", "William Blattner"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0010584.t003", "stats"=>{"downloads"=>5, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Associations_with_Pharmacy_Refill_Rx_lt_95_Among_Treatment_Na_239_ve_Adult_Nigerian_Patients_based_on_GEE_/520642", "title"=>"Associations with Pharmacy Refill (Rx) <95% Among Treatment-Naïve Adult Nigerian Patients based on GEE.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 01:27:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/850092"], "description"=>"<p>Characteristics of the Study Population (N = 5760).</p>", "links"=>[], "tags"=>["evidence-based healthcare/health services research and economics", "infectious diseases/hiv infection and aids", "public health and epidemiology/global health"], "article_id"=>520532, "categories"=>["Medicine", "Cancer"], "users"=>["Man Charurat", "Modupe Oyegunle", "Renata Benjamin", "Abdulrazaq Habib", "Emeka Eze", "Prince Ele", "Iquo Ibanga", "Samuel Ajayi", "Maria Eng", "Prosanta Mondal", "Usman Gebi", "Emilia Iwu", "Mary-Ann Etiebet", "Alash'le Abimiku", "Patrick Dakum", "John Farley", "William Blattner"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0010584.t001", "stats"=>{"downloads"=>2, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_Study_Population_N_8202_8202_5760_/520532", "title"=>"Characteristics of the Study Population (N = 5760).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-21 01:26:50"}
  • {"files"=>["https://ndownloader.figshare.com/files/849966"], "description"=>"<p>Modeled Probability of Non-adherence within the First 12 Months of ART Initiation.</p>", "links"=>[], "tags"=>["probability", "non-adherence", "12", "months"], "article_id"=>520402, "categories"=>["Medicine", "Cancer"], "users"=>["Man Charurat", "Modupe Oyegunle", "Renata Benjamin", "Abdulrazaq Habib", "Emeka Eze", "Prince Ele", "Iquo Ibanga", "Samuel Ajayi", "Maria Eng", "Prosanta Mondal", "Usman Gebi", "Emilia Iwu", "Mary-Ann Etiebet", "Alash'le Abimiku", "Patrick Dakum", "John Farley", "William Blattner"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0010584.g002", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Modeled_Probability_of_Non_adherence_within_the_First_12_Months_of_ART_Initiation_/520402", "title"=>"Modeled Probability of Non-adherence within the First 12 Months of ART Initiation.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-21 01:26:06"}
  • {"files"=>["https://ndownloader.figshare.com/files/849860"], "description"=>"<p>Study Population of Patients Initiating ART between March 2005 and July 2006.</p>", "links"=>[], "tags"=>["patients", "initiating", "2005", "july"], "article_id"=>520274, "categories"=>["Medicine", "Cancer"], "users"=>["Man Charurat", "Modupe Oyegunle", "Renata Benjamin", "Abdulrazaq Habib", "Emeka Eze", "Prince Ele", "Iquo Ibanga", "Samuel Ajayi", "Maria Eng", "Prosanta Mondal", "Usman Gebi", "Emilia Iwu", "Mary-Ann Etiebet", "Alash'le Abimiku", "Patrick Dakum", "John Farley", "William Blattner"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0010584.g001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_Population_of_Patients_Initiating_ART_between_March_2005_and_July_2006_/520274", "title"=>"Study Population of Patients Initiating ART between March 2005 and July 2006.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-21 01:25:26"}

PMC Usage Stats | Further Information

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