Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications
Background. The AIDS Drug Assistance Program (ADAP) provides antiretroviral medications to low‐income individuals with HIV infection. Methods. A prospective cohort study of ADAP utilization, measured using medication possession ratio (MPR), was conducted during the 2008 calendar year at the Universi...
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| creator | Godwin, Noah C. Willig, James H. Nevin, Christa R. Lin, Hui-Yi Allison, Jeroan Gaddis, Kathy Peterson, Jennifer Saag, Michael S. Mugavero, Michael J. Raper, James L. |
| description | Background. The AIDS Drug Assistance Program (ADAP) provides antiretroviral medications to low‐income individuals with HIV infection.
Methods. A prospective cohort study of ADAP utilization, measured using medication possession ratio (MPR), was conducted during the 2008 calendar year at the University of Alabama at Birmingham 1917 HIV Clinic. Multivariable ordinal logistic regression evaluated factors associated with ADAP utilization.
Results. Among 245 patients, MPR quartiles (Q) were the following: Q193 percent. In ordinal logistic regression, younger age (OR=0.59 per 10 years; 95 percent CI=0.44–0.79), nonwhite males (2.18; 1.18–4.04), lower CD4 count (2.79 for |
| doi_str_mv | 10.1111/j.1475-6773.2010.01223.x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3097412</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A257126674</galeid><sourcerecordid>A257126674</sourcerecordid><originalsourceid>FETCH-LOGICAL-c8003-5de11570fb71a482882b489eaf74523e6e69e5f6b0d768a9a7ea4633541375553</originalsourceid><addsrcrecordid>eNqFk19v0zAUxSMEYqXwFVAEEn8kWmzHjhMekEq7tRUVG4zB3oyb3KQuqT3iBDo-PU5buhZVI3lwdP27R_dG53iej1EXu-f1vIspZ52Q86BLkKsiTEjQXd7xWtuLu14LIcw7MSb0yHtg7RwhFAURve8dEUww4jFred8udAplXalC_ZaVMto3mV_NwO-NB-f-oKxzv2etspXUCfhnpclLuXjT1EyiZAWpfyKTypTWlzr1z0yhkmt_vLhy50rOPvTuZbKw8Ghztr2Lk-PP_VFncjoc93uTThIhFHRYChgzjrIpx5JGJIrIlEYxyIxTRgIIIYyBZeEUpTyMZCw5SBoGAaM44IyxoO29Xete1dMFpAnoqpSFuCrVQpbXwkgl9m-0monc_BQBijnFxAk83wiU5kcNthILZRMoCqnB1FZEcUhIGGL-fzKkccgIaYZ6cSuJEUERxcwt0vae_IPOTV1q98saPUYpJZGDnq6hXBYglM6MWyVpNEWPMI7dfJw6qnOAykGD29toyJQr7_HdA7x7U1io5GDDy70Gx1SwrHJZWzftcHLbMBs2MUUBOQjngf7pPv9sh5-BLKqZNUW9MtM--GoHnNZWaXBO1Vbls8quZ9nDH-_6Y2uMv1G4MdAvt-319h4j0UROzEWTLNEkSzSRE6vIiaUYHZ9_aj5vNnVpgeVWQJbfXZczqfj6YSjeXY4GHy_fT8SX4A8EMigL</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>864544428</pqid></control><display><type>article</type><title>Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Godwin, Noah C. ; Willig, James H. ; Nevin, Christa R. ; Lin, Hui-Yi ; Allison, Jeroan ; Gaddis, Kathy ; Peterson, Jennifer ; Saag, Michael S. ; Mugavero, Michael J. ; Raper, James L.</creator><creatorcontrib>Godwin, Noah C. ; Willig, James H. ; Nevin, Christa R. ; Lin, Hui-Yi ; Allison, Jeroan ; Gaddis, Kathy ; Peterson, Jennifer ; Saag, Michael S. ; Mugavero, Michael J. ; Raper, James L.</creatorcontrib><description>Background. The AIDS Drug Assistance Program (ADAP) provides antiretroviral medications to low‐income individuals with HIV infection.
Methods. A prospective cohort study of ADAP utilization, measured using medication possession ratio (MPR), was conducted during the 2008 calendar year at the University of Alabama at Birmingham 1917 HIV Clinic. Multivariable ordinal logistic regression evaluated factors associated with ADAP utilization.
Results. Among 245 patients, MPR quartiles (Q) were the following: Q1<69 percent, Q2=69–83 percent, Q3=84–93 percent, Q4>93 percent. In ordinal logistic regression, younger age (OR=0.59 per 10 years; 95 percent CI=0.44–0.79), nonwhite males (2.18; 1.18–4.04), lower CD4 count (2.79 for <200 cells/mm3; 1.44–5.43), and a history of alcohol abuse (2.11; 1.02–4.37) were associated with poor ADAP utilization.
Conclusions. One quarter of ADAP enrollees had MPR below 69 percent, a level well below that associated with optimal HIV treatment outcomes, indicating a need for programmatic interventions to improve ADAP utilization.</description><identifier>ISSN: 0017-9124</identifier><identifier>EISSN: 1475-6773</identifier><identifier>DOI: 10.1111/j.1475-6773.2010.01223.x</identifier><identifier>PMID: 21210795</identifier><identifier>CODEN: HESEA5</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Acquired immune deficiency syndrome ; adherence ; Adult ; Age ; AIDS ; AIDS (Disease) ; AIDS treatment ; Alabama ; Alcoholism ; Analysis ; Anti-HIV agents ; Anti-HIV Agents - economics ; Antiviral agents ; CD4 antigen ; Clinical outcomes ; Clinics ; Cohort analysis ; Drug abuse ; Drugs ; Female ; Health aspects ; Health Policy ; Health services utilization ; HIV ; HIV (Viruses) ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Immune response system ; Infection ; Insurance, Pharmaceutical Services - utilization ; Logistic Models ; Low income people ; Male ; Medical Assistance - utilization ; Medical research ; Medication Adherence ; Medicine, Experimental ; Multivariate Analysis ; Prescription drug plans ; Prospective Studies ; Public health ; Research Brief ; Risk Factors ; Social security ; Studies</subject><ispartof>Health services research, 2011-06, Vol.46 (3), p.982-995</ispartof><rights>Health Research and Educational Trust</rights><rights>Health Research and Educational Trust.</rights><rights>COPYRIGHT 2011 Health Research and Educational Trust</rights><rights>2011 Health Research and Education Trust 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c8003-5de11570fb71a482882b489eaf74523e6e69e5f6b0d768a9a7ea4633541375553</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097412/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097412/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,30976,30977,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21210795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Godwin, Noah C.</creatorcontrib><creatorcontrib>Willig, James H.</creatorcontrib><creatorcontrib>Nevin, Christa R.</creatorcontrib><creatorcontrib>Lin, Hui-Yi</creatorcontrib><creatorcontrib>Allison, Jeroan</creatorcontrib><creatorcontrib>Gaddis, Kathy</creatorcontrib><creatorcontrib>Peterson, Jennifer</creatorcontrib><creatorcontrib>Saag, Michael S.</creatorcontrib><creatorcontrib>Mugavero, Michael J.</creatorcontrib><creatorcontrib>Raper, James L.</creatorcontrib><title>Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications</title><title>Health services research</title><addtitle>Health Serv Res</addtitle><description>Background. The AIDS Drug Assistance Program (ADAP) provides antiretroviral medications to low‐income individuals with HIV infection.
Methods. A prospective cohort study of ADAP utilization, measured using medication possession ratio (MPR), was conducted during the 2008 calendar year at the University of Alabama at Birmingham 1917 HIV Clinic. Multivariable ordinal logistic regression evaluated factors associated with ADAP utilization.
Results. Among 245 patients, MPR quartiles (Q) were the following: Q1<69 percent, Q2=69–83 percent, Q3=84–93 percent, Q4>93 percent. In ordinal logistic regression, younger age (OR=0.59 per 10 years; 95 percent CI=0.44–0.79), nonwhite males (2.18; 1.18–4.04), lower CD4 count (2.79 for <200 cells/mm3; 1.44–5.43), and a history of alcohol abuse (2.11; 1.02–4.37) were associated with poor ADAP utilization.
Conclusions. One quarter of ADAP enrollees had MPR below 69 percent, a level well below that associated with optimal HIV treatment outcomes, indicating a need for programmatic interventions to improve ADAP utilization.</description><subject>Acquired immune deficiency syndrome</subject><subject>adherence</subject><subject>Adult</subject><subject>Age</subject><subject>AIDS</subject><subject>AIDS (Disease)</subject><subject>AIDS treatment</subject><subject>Alabama</subject><subject>Alcoholism</subject><subject>Analysis</subject><subject>Anti-HIV agents</subject><subject>Anti-HIV Agents - economics</subject><subject>Antiviral agents</subject><subject>CD4 antigen</subject><subject>Clinical outcomes</subject><subject>Clinics</subject><subject>Cohort analysis</subject><subject>Drug abuse</subject><subject>Drugs</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Policy</subject><subject>Health services utilization</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immune response system</subject><subject>Infection</subject><subject>Insurance, Pharmaceutical Services - utilization</subject><subject>Logistic Models</subject><subject>Low income people</subject><subject>Male</subject><subject>Medical Assistance - utilization</subject><subject>Medical research</subject><subject>Medication Adherence</subject><subject>Medicine, Experimental</subject><subject>Multivariate Analysis</subject><subject>Prescription drug plans</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Research Brief</subject><subject>Risk Factors</subject><subject>Social security</subject><subject>Studies</subject><issn>0017-9124</issn><issn>1475-6773</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>N95</sourceid><sourceid>7QJ</sourceid><recordid>eNqFk19v0zAUxSMEYqXwFVAEEn8kWmzHjhMekEq7tRUVG4zB3oyb3KQuqT3iBDo-PU5buhZVI3lwdP27R_dG53iej1EXu-f1vIspZ52Q86BLkKsiTEjQXd7xWtuLu14LIcw7MSb0yHtg7RwhFAURve8dEUww4jFred8udAplXalC_ZaVMto3mV_NwO-NB-f-oKxzv2etspXUCfhnpclLuXjT1EyiZAWpfyKTypTWlzr1z0yhkmt_vLhy50rOPvTuZbKw8Ghztr2Lk-PP_VFncjoc93uTThIhFHRYChgzjrIpx5JGJIrIlEYxyIxTRgIIIYyBZeEUpTyMZCw5SBoGAaM44IyxoO29Xete1dMFpAnoqpSFuCrVQpbXwkgl9m-0monc_BQBijnFxAk83wiU5kcNthILZRMoCqnB1FZEcUhIGGL-fzKkccgIaYZ6cSuJEUERxcwt0vae_IPOTV1q98saPUYpJZGDnq6hXBYglM6MWyVpNEWPMI7dfJw6qnOAykGD29toyJQr7_HdA7x7U1io5GDDy70Gx1SwrHJZWzftcHLbMBs2MUUBOQjngf7pPv9sh5-BLKqZNUW9MtM--GoHnNZWaXBO1Vbls8quZ9nDH-_6Y2uMv1G4MdAvt-319h4j0UROzEWTLNEkSzSRE6vIiaUYHZ9_aj5vNnVpgeVWQJbfXZczqfj6YSjeXY4GHy_fT8SX4A8EMigL</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Godwin, Noah C.</creator><creator>Willig, James H.</creator><creator>Nevin, Christa R.</creator><creator>Lin, Hui-Yi</creator><creator>Allison, Jeroan</creator><creator>Gaddis, Kathy</creator><creator>Peterson, Jennifer</creator><creator>Saag, Michael S.</creator><creator>Mugavero, Michael J.</creator><creator>Raper, James L.</creator><general>Blackwell Publishing Inc</general><general>Health Research and Educational Trust</general><general>Blackwell Publishing Ltd</general><general>Blackwell Science Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>N95</scope><scope>XI7</scope><scope>8GL</scope><scope>7QJ</scope><scope>K9.</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201106</creationdate><title>Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications</title><author>Godwin, Noah C. ; Willig, James H. ; Nevin, Christa R. ; Lin, Hui-Yi ; Allison, Jeroan ; Gaddis, Kathy ; Peterson, Jennifer ; Saag, Michael S. ; Mugavero, Michael J. ; Raper, James L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c8003-5de11570fb71a482882b489eaf74523e6e69e5f6b0d768a9a7ea4633541375553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>adherence</topic><topic>Adult</topic><topic>Age</topic><topic>AIDS</topic><topic>AIDS (Disease)</topic><topic>AIDS treatment</topic><topic>Alabama</topic><topic>Alcoholism</topic><topic>Analysis</topic><topic>Anti-HIV agents</topic><topic>Anti-HIV Agents - economics</topic><topic>Antiviral agents</topic><topic>CD4 antigen</topic><topic>Clinical outcomes</topic><topic>Clinics</topic><topic>Cohort analysis</topic><topic>Drug abuse</topic><topic>Drugs</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Policy</topic><topic>Health services utilization</topic><topic>HIV</topic><topic>HIV (Viruses)</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immune response system</topic><topic>Infection</topic><topic>Insurance, Pharmaceutical Services - utilization</topic><topic>Logistic Models</topic><topic>Low income people</topic><topic>Male</topic><topic>Medical Assistance - utilization</topic><topic>Medical research</topic><topic>Medication Adherence</topic><topic>Medicine, Experimental</topic><topic>Multivariate Analysis</topic><topic>Prescription drug plans</topic><topic>Prospective Studies</topic><topic>Public health</topic><topic>Research Brief</topic><topic>Risk Factors</topic><topic>Social security</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Godwin, Noah C.</creatorcontrib><creatorcontrib>Willig, James H.</creatorcontrib><creatorcontrib>Nevin, Christa R.</creatorcontrib><creatorcontrib>Lin, Hui-Yi</creatorcontrib><creatorcontrib>Allison, Jeroan</creatorcontrib><creatorcontrib>Gaddis, Kathy</creatorcontrib><creatorcontrib>Peterson, Jennifer</creatorcontrib><creatorcontrib>Saag, Michael S.</creatorcontrib><creatorcontrib>Mugavero, Michael J.</creatorcontrib><creatorcontrib>Raper, James L.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Gale Business: Insights</collection><collection>Business Insights: Essentials</collection><collection>Gale In Context: High School</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Godwin, Noah C.</au><au>Willig, James H.</au><au>Nevin, Christa R.</au><au>Lin, Hui-Yi</au><au>Allison, Jeroan</au><au>Gaddis, Kathy</au><au>Peterson, Jennifer</au><au>Saag, Michael S.</au><au>Mugavero, Michael J.</au><au>Raper, James L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications</atitle><jtitle>Health services research</jtitle><addtitle>Health Serv Res</addtitle><date>2011-06</date><risdate>2011</risdate><volume>46</volume><issue>3</issue><spage>982</spage><epage>995</epage><pages>982-995</pages><issn>0017-9124</issn><eissn>1475-6773</eissn><coden>HESEA5</coden><abstract>Background. The AIDS Drug Assistance Program (ADAP) provides antiretroviral medications to low‐income individuals with HIV infection.
Methods. A prospective cohort study of ADAP utilization, measured using medication possession ratio (MPR), was conducted during the 2008 calendar year at the University of Alabama at Birmingham 1917 HIV Clinic. Multivariable ordinal logistic regression evaluated factors associated with ADAP utilization.
Results. Among 245 patients, MPR quartiles (Q) were the following: Q1<69 percent, Q2=69–83 percent, Q3=84–93 percent, Q4>93 percent. In ordinal logistic regression, younger age (OR=0.59 per 10 years; 95 percent CI=0.44–0.79), nonwhite males (2.18; 1.18–4.04), lower CD4 count (2.79 for <200 cells/mm3; 1.44–5.43), and a history of alcohol abuse (2.11; 1.02–4.37) were associated with poor ADAP utilization.
Conclusions. One quarter of ADAP enrollees had MPR below 69 percent, a level well below that associated with optimal HIV treatment outcomes, indicating a need for programmatic interventions to improve ADAP utilization.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>21210795</pmid><doi>10.1111/j.1475-6773.2010.01223.x</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acquired immune deficiency syndrome adherence Adult Age AIDS AIDS (Disease) AIDS treatment Alabama Alcoholism Analysis Anti-HIV agents Anti-HIV Agents - economics Antiviral agents CD4 antigen Clinical outcomes Clinics Cohort analysis Drug abuse Drugs Female Health aspects Health Policy Health services utilization HIV HIV (Viruses) HIV Infections - drug therapy Human immunodeficiency virus Humans Immune response system Infection Insurance, Pharmaceutical Services - utilization Logistic Models Low income people Male Medical Assistance - utilization Medical research Medication Adherence Medicine, Experimental Multivariate Analysis Prescription drug plans Prospective Studies Public health Research Brief Risk Factors Social security Studies |
| title | Underutilization of the AIDS Drug Assistance Program: Associated Factors and Policy Implications |
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