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...

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Publicado en:AIDS Patient Care & STDs Vol. 25; no. 3; pp. 191 - 201
Autores principales: Malee, Kathleen, Williams, Paige, Montepiedra, Grace, McCabe, Marie, Nichols, Sharon, Sirois, Patricia A., Storm, Deborah, Farley, John, Kammerer, and the PACTG 219C Team, Betsy
Formato: clinical trial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Mar2011
Acceso en línea:Ver este registro en EBSCOhost
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        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
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