Medication Adherence in Children and Adolescents with HIV Infection: Associations with Behavioral Impairment.
The impact of behavioral functioning on medication adherence in children with perinatally acquired HIV infection is not well-explored, but has important implications for intervention. This report addresses the relationship between behavioral functioning and child self-report or caregiver report of m...
| Publicado en: | AIDS Patient Care & STDs Vol. 25; no. 3; pp. 191 - 201 |
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| Autores principales: | , , , , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Mar2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104837692&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104837692 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10872914 33C jtl: AIDS Patient Care & STDs issn: 10872914 maglogo: N pubinfo: dt: Mar2011 vid: 25 iid: 3 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 104837692 58844753 10.1089/apc.2010.0181 NLM21323533 104837692 ppf: 191 ppct: 10 formats: tig: atl: Medication Adherence in Children and Adolescents with HIV Infection: Associations with Behavioral Impairment. aug: au: Malee, Kathleen Williams, Paige Montepiedra, Grace McCabe, Marie Nichols, Sharon Sirois, Patricia A. Storm, Deborah Farley, John Kammerer, and the PACTG 219C Team, Betsy affil: Department of Child and Adolescent Psychiatry, , Chicago, Illinois. sug: subj: Medication Compliance In Infancy and Childhood Medication Compliance In Adolescence Anti-HIV Agents In Infancy and Childhood Anti-HIV Agents In Adolescence Child Behavior Adolescent Behavior Child Behavior Disorders Human Child Adolescence Male Female Self Report Caregivers Child, Preschool Clinical Trials Multiple Logistic Regression Medication Compliance Evaluation Odds Ratio United States Puerto Rico Secondary Analysis Fisher's Exact Test Behavior Rating Scales Questionnaires Quality of Life Evaluation T-Tests Viral Load CD4 Lymphocyte Count Child Behavior Evaluation Antiretroviral Therapy, Highly Active Child Behavior Disorders Classification Cross Sectional Studies Descriptive Research Descriptive Statistics Funding Source Child: 6-12 years Adolescent: 13-18 years Child, Preschool: 2-5 years Male Female ab: The impact of behavioral functioning on medication adherence in children with perinatally acquired HIV infection is not well-explored, but has important implications for intervention. This report addresses the relationship between behavioral functioning and child self-report or caregiver report of medication adherence among children and adolescents enrolled in Pediatric AIDS Clinical Trials Group Protocol 219C (conducted 2000-2007). A total of 1134 participants, aged 3-17 years, received a behavioral evaluation and adherence assessment. Complete adherence was defined as taking 100% of prescribed antiretroviral medications during three days preceding the study visit. Multivariable logistic regression models were used to evaluate associations between adherence and behavioral functioning, adjusting for potential confounders, including demographic, psychosocial, and health factors. Children demonstrated higher than expected rates of behavioral impairment (≈7% expected with T > 65) in the areas of conduct problems (14%, z = 7.0, p < 0.001), learning problems (22%, z = 12.2, p < 0.001), somatic complaints (22%, z = 12.6, p < 0.001), impulsivity-hyperactivity (20%, z = 11.1, p < 0.001), and hyperactivity (19%, z = 10.6, p < 0.001). Children with behavioral impairment in one or more areas had significantly increased odds of nonadherence [adjusted odds ratio (aOR) = 1.49, p = 0.04]. The odds of nonadherence were significantly higher for those with conduct problems and general hyperactivity (aOR = 2.03, p = 0.005 and aOR = 1.68, p = 0.02, respectively). Psychosocial and health factors, such as recent stressful life events and higher HIV RNA levels, were also associated with nonadherence. Knowledge of behavioral, health, and social influences affecting the child and family should guide the development of appropriate, evidence-based interventions for medication adherence. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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