College of Nursing and Health Science
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Browsing College of Nursing and Health Science by Subject "adherence"
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Item 90-90-90-plus: Maintaining adherence to antiretroviral therapies(Mary Ann Liebert, 2017-05-01) Corless, Inge; Hoyt, Alex; Tyer-Viola, Lynda; Sefcik, Elizabeth; Kemppainen, Jeanne; Holzemer, William; Sanzero Eller, Lucille; Nokes, Kathleen; Phillips, J. Craig; Dawson Rose, Carol; Rivero-Mendez, Marta; Iipinge, Scholastika Ndatinda; Chaiphibalsarisdi, Puangtip; Portillo, Carmen J.; Chen, Wei-Ti; Webel, Allison; Brion, John; Johnson, Mallory O.; Voss, Joachim; Hamilton, Mary Jane; Sullivan, Kathleen M.; Kirksey, Kenn; Nicholas, Patrice; Corless, Inge; Hoyt, Alex; Tyer-Viola, Lynda; Sefcik, Elizabeth; Kemppainen, Jeanne; Holzemer, William; Sanzero Eller, Lucille; Nokes, Kathleen; Phillips, J. Craig; Dawson Rose, Carol; Rivero-Mendez, Marta; Iipinge, Scholastika Ndatinda; Chaiphibalsarisdi, Puangtip; Portillo, Carmen J.; Chen, Wei-Ti; Webel, Allison; Brion, John; Johnson, Mallory O.; Voss, Joachim; Hamilton, Mary Jane; Sullivan, Kathleen M.; Kirksey, Kenn; Nicholas, PatriceMedication adherence is the “Plus” in the global challenge to have 90% of HIV-infected individuals tested, 90% of those who are HIV positive treated, and 90% of those treated achieve an undetectable viral load. The latter indicates viral suppression, the goal for clinicians treating people living with HIV (PLWH). The comparative importance of different psychosocial scales in predicting the level of antiretroviral adherence, however, has been little studied. Using data from a cross-sectional study of medication adherence with an international convenience sample of 1811 PLWH, we categorized respondent medication adherence as None (0%), Low (1–60%), Moderate (61–94%), and High (95–100%) adherence based on self-report. The survey contained 13 psychosocial scales/indices, all of which were correlated with one another (p < 0.05 or less) and had differing degrees of association with the levels of adherence. Controlling for the influence of race, gender, education, and ability to pay for care, all scales/indices were associated with adherence, with the exception of Berger's perceived stigma scale. Using forward selection stepwise regression, we found that adherence self-efficacy, depression, stressful life events, and perceived stigma were significant predictors of medication adherence. Among the demographic variables entered into the model, nonwhite race was associated with double the odds of being in the None rather than in the High adherence category, suggesting these individuals may require additional support. In addition, asking about self-efficacy, depression, stigma, and stressful life events also will be beneficial in identifying patients requiring greater adherence support. This support is essential to medication adherence, the Plus to 90-90-90.Item Mediators of antiretroviral adherence: A multisite international study(Taylor and Franics Online, 2013-03) Corless, Inge; Guarino, Alessio; Nicholas, Patrice; Tyer-Viola, Lynda; Kirksey, Kenn; Brion, John; Dawson Rose, Carol; Sanzero Eller, Lucille; Rivero-Mendez, Marta; Kemppainen, Jeanne; Nokes, Kathleen; Sefcik, Elizabeth; Voss, Joachim; Wantland, dean; Johnson, Mallory O.; Phillips, J. Craig; Webel, A.; Iipinge, Scholastika Ndatinda; Portillo, Carmen; Chen, Wei-ti; Maryland, M.; Hamilton, M.J.; Reid, P.; Hickey, D.; Holzemer, William; Sullivan, K.; Corless, Inge; Guarino, Alessio; Nicholas, Patrice; Tyer-Viola, Lynda; Kirksey, Kenn; Brion, John; Dawson Rose, Carol; Sanzero Eller, Lucille; Rivero-Mendez, Marta; Kemppainen, Jeanne; Nokes, Kathleen; Sefcik, Elizabeth; Voss, Joachim; Wantland, dean; Johnson, Mallory O.; Phillips, J. Craig; Webel, A.; Iipinge, Scholastika Ndatinda; Portillo, Carmen; Chen, Wei-ti; Maryland, M.; Hamilton, M.J.; Reid, P.; Hickey, D.; Holzemer, William; Sullivan, K.The purpose of this study was to investigate the effects of stressful life events (SLE) on medication adherence (3 days, 30 days) as mediated by sense of coherence (SOC), self-compassion (SCS), and engagement with the healthcare provider (eHCP) and whether this differed by international site. Data were obtained from a cross-sectional sample of 2082 HIV positive adults between September 2009 and January 2011 from sites in Canada, China, Namibia, Puerto Rico, Thailand, and US. Statistical tests to explore the effects of stressful life events on antiretroviral medication adherence included descriptive statistics, multivariate analysis of variance, analysis of variance with Bonferroni post-hoc analysis, and path analysis. An examination by international site of the relationships between SLE, SCS, SOC, and eHCP with adherence (3 days and 30 days) indicated these combined variables were related to adherence whether 3 days or 30 days to different degrees at the various sites. SLE, SCS, SOC, and eHCP were significant predictors of adherence past 3 days for the United States (p = < 0.001), Canada (p = 0.006), and Namibia (p = 0.019). The combined independent variables were significant predictors of adherence past 30 days only in the United States and Canada. Engagement with the provider was a significant correlate for antiretroviral adherence in most, but not all, of these countries. Thus, the importance of eHCP cannot be overstated. Nonetheless, our findings need to be accompanied by the caveat that research on variables of interest, while enriched by a sample obtained from international sites, may not have the same relationships in each country.