Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots
Study Objective To assess the association between tenofovir diphosphate (TFV‐DP) in dried blood spots (DBS), a measure of cumulative tenofovir‐based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH). Design Prospective clinical coho...
Gespeichert in:
| Veröffentlicht in: | Pharmacotherapy 2021-03, Vol.41 (3), p.291-298 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 298 |
|---|---|
| container_issue | 3 |
| container_start_page | 291 |
| container_title | Pharmacotherapy |
| container_volume | 41 |
| creator | Saderup, Austin M. Morrow, Mary Libby, Anne M. Coyle, Ryan P. Coleman, Stacey S. Zheng, Jia‐Hua Ellison, Lucas Bushman, Lane R. Kiser, Jennifer J. MaWhinney, Samantha Anderson, Peter L. Castillo‐Mancilla, Jose R. |
| description | Study Objective
To assess the association between tenofovir diphosphate (TFV‐DP) in dried blood spots (DBS), a measure of cumulative tenofovir‐based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH).
Design
Prospective clinical cohort (up to three visits over 48 weeks).
Setting
Academic‐based HIV clinic.
Patients
PWH receiving tenofovir disoproxil fumarate (TDF)‐based ART.
Measurements
DBS for TFV‐DP were collected at every study visit. Baseline patient‐level medication regimen complexity index (pMRCI) scores were calculated and categorized into three sub‐scores (disease‐specific [ART], non‐ART, and over‐the‐counter [OTC]). The pMRCI scores were evaluated to assess the association with TFV‐DP in DBS |
| doi_str_mv | 10.1002/phar.2490 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7946741</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2490605849</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4430-6dd99a1eb8288e18c39da4974eee7114ef6b36ec0ee94ac197ac4163fe26b91e3</originalsourceid><addsrcrecordid>eNp1kU9rFDEchoModm09-AUk4MUepk0m2fy5CKW0bqGgiPUaMpnfdFJmJ2OS7brfvpluLSp4CiQPD--bF6F3lJxQQurTqbfxpOaavEALquSy0pTyl2hBaikrQog6QG9SuisoFbx-jQ4YW2ou2XKB8srf9hDxGlrvbPZhxC6spwF--bzDfsQTxBTGhLc-93h19QP7hG1KwXmbod1fD2FbFBnG0IV7H3Hrpz6kkirDrGijL2QzhNDiNIWcjtCrzg4J3j6dh-jm8uL7-aq6_vL56vzsunKcM1KJttXaUmhUrRRQ5ZhuLdeSA4AsDaETDRPgCIDm1lEtreNUsA5q0WgK7BB92nunTVMKOhhztIOZol_buDPBevP3y-h7cxvujdRcSE6L4OOTIIafG0jZrH1yMAx2hLBJZv5zQZaK64J--Ae9C5s4lnozpcoiQrFCHe8pF0NKEbrnMJSYeUszb_noLez7P9M_k7_HK8DpHtj6AXb_N5mvq7Nvj8oHIpWsRw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2498911683</pqid></control><display><type>article</type><title>Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Saderup, Austin M. ; Morrow, Mary ; Libby, Anne M. ; Coyle, Ryan P. ; Coleman, Stacey S. ; Zheng, Jia‐Hua ; Ellison, Lucas ; Bushman, Lane R. ; Kiser, Jennifer J. ; MaWhinney, Samantha ; Anderson, Peter L. ; Castillo‐Mancilla, Jose R.</creator><creatorcontrib>Saderup, Austin M. ; Morrow, Mary ; Libby, Anne M. ; Coyle, Ryan P. ; Coleman, Stacey S. ; Zheng, Jia‐Hua ; Ellison, Lucas ; Bushman, Lane R. ; Kiser, Jennifer J. ; MaWhinney, Samantha ; Anderson, Peter L. ; Castillo‐Mancilla, Jose R.</creatorcontrib><description>Study Objective
To assess the association between tenofovir diphosphate (TFV‐DP) in dried blood spots (DBS), a measure of cumulative tenofovir‐based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH).
Design
Prospective clinical cohort (up to three visits over 48 weeks).
Setting
Academic‐based HIV clinic.
Patients
PWH receiving tenofovir disoproxil fumarate (TDF)‐based ART.
Measurements
DBS for TFV‐DP were collected at every study visit. Baseline patient‐level medication regimen complexity index (pMRCI) scores were calculated and categorized into three sub‐scores (disease‐specific [ART], non‐ART, and over‐the‐counter [OTC]). The pMRCI scores were evaluated to assess the association with TFV‐DP in DBS <350 fmol/punch after adjusting for clinical covariates. pMRCI scores were also categorized to estimate the adjusted relative risk (aRR) of having a TFV‐DP <350 fmol/punch between pMRCI quartiles.
Main Results
Data from 525 participants (1,146 person‐visits) were analyzed. Baseline median (interquartile range [IQR]) pMRCI scores for participants with TFV‐DP in DBS <350 vs. ≥350 fmol/punch were 4 (3, 8) vs. 4 (2, 6) for ART, 27 (12, 31) vs. 12 (5, 22) for non‐ART, and 0 (0, 1) vs. 0 (0, 2) for OTC, respectively. For the non‐ART scores, the aRR for having a TFV‐DP in DBS <350 fmol/punch was 6.4 (95% CI: 2.0, 20.6; P=0.002) when comparing participants in the highest pMRCI quartile with those in the lowest quartile.
Conclusions
Higher pMRCI for non‐ART medications is associated with lower adherence as measured by TFV‐DP in DBS. Future research should investigate whether reducing non‐ART medication complexity improves ART adherence and exposure in PWH.</description><identifier>ISSN: 0277-0008</identifier><identifier>EISSN: 1875-9114</identifier><identifier>DOI: 10.1002/phar.2490</identifier><identifier>PMID: 33594735</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adenine - analogs & derivatives ; Adenine - analysis ; adherence ; Antiretroviral drugs ; Antiretroviral therapy ; Dried Blood Spot Testing ; dried blood spots ; HIV ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Medication Regimen Complexity Index ; Organophosphates - analysis ; Prospective Studies ; Tenofovir</subject><ispartof>Pharmacotherapy, 2021-03, Vol.41 (3), p.291-298</ispartof><rights>2020 Pharmacotherapy Publications, Inc.</rights><rights>2021 Pharmacotherapy Publications, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4430-6dd99a1eb8288e18c39da4974eee7114ef6b36ec0ee94ac197ac4163fe26b91e3</citedby><cites>FETCH-LOGICAL-c4430-6dd99a1eb8288e18c39da4974eee7114ef6b36ec0ee94ac197ac4163fe26b91e3</cites><orcidid>0000-0003-1242-1745</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fphar.2490$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fphar.2490$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33594735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saderup, Austin M.</creatorcontrib><creatorcontrib>Morrow, Mary</creatorcontrib><creatorcontrib>Libby, Anne M.</creatorcontrib><creatorcontrib>Coyle, Ryan P.</creatorcontrib><creatorcontrib>Coleman, Stacey S.</creatorcontrib><creatorcontrib>Zheng, Jia‐Hua</creatorcontrib><creatorcontrib>Ellison, Lucas</creatorcontrib><creatorcontrib>Bushman, Lane R.</creatorcontrib><creatorcontrib>Kiser, Jennifer J.</creatorcontrib><creatorcontrib>MaWhinney, Samantha</creatorcontrib><creatorcontrib>Anderson, Peter L.</creatorcontrib><creatorcontrib>Castillo‐Mancilla, Jose R.</creatorcontrib><title>Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots</title><title>Pharmacotherapy</title><addtitle>Pharmacotherapy</addtitle><description>Study Objective
To assess the association between tenofovir diphosphate (TFV‐DP) in dried blood spots (DBS), a measure of cumulative tenofovir‐based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH).
Design
Prospective clinical cohort (up to three visits over 48 weeks).
Setting
Academic‐based HIV clinic.
Patients
PWH receiving tenofovir disoproxil fumarate (TDF)‐based ART.
Measurements
DBS for TFV‐DP were collected at every study visit. Baseline patient‐level medication regimen complexity index (pMRCI) scores were calculated and categorized into three sub‐scores (disease‐specific [ART], non‐ART, and over‐the‐counter [OTC]). The pMRCI scores were evaluated to assess the association with TFV‐DP in DBS <350 fmol/punch after adjusting for clinical covariates. pMRCI scores were also categorized to estimate the adjusted relative risk (aRR) of having a TFV‐DP <350 fmol/punch between pMRCI quartiles.
Main Results
Data from 525 participants (1,146 person‐visits) were analyzed. Baseline median (interquartile range [IQR]) pMRCI scores for participants with TFV‐DP in DBS <350 vs. ≥350 fmol/punch were 4 (3, 8) vs. 4 (2, 6) for ART, 27 (12, 31) vs. 12 (5, 22) for non‐ART, and 0 (0, 1) vs. 0 (0, 2) for OTC, respectively. For the non‐ART scores, the aRR for having a TFV‐DP in DBS <350 fmol/punch was 6.4 (95% CI: 2.0, 20.6; P=0.002) when comparing participants in the highest pMRCI quartile with those in the lowest quartile.
Conclusions
Higher pMRCI for non‐ART medications is associated with lower adherence as measured by TFV‐DP in DBS. Future research should investigate whether reducing non‐ART medication complexity improves ART adherence and exposure in PWH.</description><subject>Adenine - analogs & derivatives</subject><subject>Adenine - analysis</subject><subject>adherence</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Dried Blood Spot Testing</subject><subject>dried blood spots</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Medication Regimen Complexity Index</subject><subject>Organophosphates - analysis</subject><subject>Prospective Studies</subject><subject>Tenofovir</subject><issn>0277-0008</issn><issn>1875-9114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9rFDEchoModm09-AUk4MUepk0m2fy5CKW0bqGgiPUaMpnfdFJmJ2OS7brfvpluLSp4CiQPD--bF6F3lJxQQurTqbfxpOaavEALquSy0pTyl2hBaikrQog6QG9SuisoFbx-jQ4YW2ou2XKB8srf9hDxGlrvbPZhxC6spwF--bzDfsQTxBTGhLc-93h19QP7hG1KwXmbod1fD2FbFBnG0IV7H3Hrpz6kkirDrGijL2QzhNDiNIWcjtCrzg4J3j6dh-jm8uL7-aq6_vL56vzsunKcM1KJttXaUmhUrRRQ5ZhuLdeSA4AsDaETDRPgCIDm1lEtreNUsA5q0WgK7BB92nunTVMKOhhztIOZol_buDPBevP3y-h7cxvujdRcSE6L4OOTIIafG0jZrH1yMAx2hLBJZv5zQZaK64J--Ae9C5s4lnozpcoiQrFCHe8pF0NKEbrnMJSYeUszb_noLez7P9M_k7_HK8DpHtj6AXb_N5mvq7Nvj8oHIpWsRw</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Saderup, Austin M.</creator><creator>Morrow, Mary</creator><creator>Libby, Anne M.</creator><creator>Coyle, Ryan P.</creator><creator>Coleman, Stacey S.</creator><creator>Zheng, Jia‐Hua</creator><creator>Ellison, Lucas</creator><creator>Bushman, Lane R.</creator><creator>Kiser, Jennifer J.</creator><creator>MaWhinney, Samantha</creator><creator>Anderson, Peter L.</creator><creator>Castillo‐Mancilla, Jose R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1242-1745</orcidid></search><sort><creationdate>202103</creationdate><title>Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots</title><author>Saderup, Austin M. ; Morrow, Mary ; Libby, Anne M. ; Coyle, Ryan P. ; Coleman, Stacey S. ; Zheng, Jia‐Hua ; Ellison, Lucas ; Bushman, Lane R. ; Kiser, Jennifer J. ; MaWhinney, Samantha ; Anderson, Peter L. ; Castillo‐Mancilla, Jose R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4430-6dd99a1eb8288e18c39da4974eee7114ef6b36ec0ee94ac197ac4163fe26b91e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adenine - analogs & derivatives</topic><topic>Adenine - analysis</topic><topic>adherence</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Dried Blood Spot Testing</topic><topic>dried blood spots</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Medication Regimen Complexity Index</topic><topic>Organophosphates - analysis</topic><topic>Prospective Studies</topic><topic>Tenofovir</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saderup, Austin M.</creatorcontrib><creatorcontrib>Morrow, Mary</creatorcontrib><creatorcontrib>Libby, Anne M.</creatorcontrib><creatorcontrib>Coyle, Ryan P.</creatorcontrib><creatorcontrib>Coleman, Stacey S.</creatorcontrib><creatorcontrib>Zheng, Jia‐Hua</creatorcontrib><creatorcontrib>Ellison, Lucas</creatorcontrib><creatorcontrib>Bushman, Lane R.</creatorcontrib><creatorcontrib>Kiser, Jennifer J.</creatorcontrib><creatorcontrib>MaWhinney, Samantha</creatorcontrib><creatorcontrib>Anderson, Peter L.</creatorcontrib><creatorcontrib>Castillo‐Mancilla, Jose R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saderup, Austin M.</au><au>Morrow, Mary</au><au>Libby, Anne M.</au><au>Coyle, Ryan P.</au><au>Coleman, Stacey S.</au><au>Zheng, Jia‐Hua</au><au>Ellison, Lucas</au><au>Bushman, Lane R.</au><au>Kiser, Jennifer J.</au><au>MaWhinney, Samantha</au><au>Anderson, Peter L.</au><au>Castillo‐Mancilla, Jose R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots</atitle><jtitle>Pharmacotherapy</jtitle><addtitle>Pharmacotherapy</addtitle><date>2021-03</date><risdate>2021</risdate><volume>41</volume><issue>3</issue><spage>291</spage><epage>298</epage><pages>291-298</pages><issn>0277-0008</issn><eissn>1875-9114</eissn><abstract>Study Objective
To assess the association between tenofovir diphosphate (TFV‐DP) in dried blood spots (DBS), a measure of cumulative tenofovir‐based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH).
Design
Prospective clinical cohort (up to three visits over 48 weeks).
Setting
Academic‐based HIV clinic.
Patients
PWH receiving tenofovir disoproxil fumarate (TDF)‐based ART.
Measurements
DBS for TFV‐DP were collected at every study visit. Baseline patient‐level medication regimen complexity index (pMRCI) scores were calculated and categorized into three sub‐scores (disease‐specific [ART], non‐ART, and over‐the‐counter [OTC]). The pMRCI scores were evaluated to assess the association with TFV‐DP in DBS <350 fmol/punch after adjusting for clinical covariates. pMRCI scores were also categorized to estimate the adjusted relative risk (aRR) of having a TFV‐DP <350 fmol/punch between pMRCI quartiles.
Main Results
Data from 525 participants (1,146 person‐visits) were analyzed. Baseline median (interquartile range [IQR]) pMRCI scores for participants with TFV‐DP in DBS <350 vs. ≥350 fmol/punch were 4 (3, 8) vs. 4 (2, 6) for ART, 27 (12, 31) vs. 12 (5, 22) for non‐ART, and 0 (0, 1) vs. 0 (0, 2) for OTC, respectively. For the non‐ART scores, the aRR for having a TFV‐DP in DBS <350 fmol/punch was 6.4 (95% CI: 2.0, 20.6; P=0.002) when comparing participants in the highest pMRCI quartile with those in the lowest quartile.
Conclusions
Higher pMRCI for non‐ART medications is associated with lower adherence as measured by TFV‐DP in DBS. Future research should investigate whether reducing non‐ART medication complexity improves ART adherence and exposure in PWH.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33594735</pmid><doi>10.1002/phar.2490</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1242-1745</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0277-0008 |
| ispartof | Pharmacotherapy, 2021-03, Vol.41 (3), p.291-298 |
| issn | 0277-0008 1875-9114 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7946741 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adenine - analogs & derivatives Adenine - analysis adherence Antiretroviral drugs Antiretroviral therapy Dried Blood Spot Testing dried blood spots HIV HIV Infections - drug therapy Human immunodeficiency virus Humans Medication Regimen Complexity Index Organophosphates - analysis Prospective Studies Tenofovir |
| title | Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T22%3A26%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Higher%20medication%20complexity%20in%20persons%20with%20HIV%20is%20associated%20with%20lower%20tenofovir%20diphosphate%20in%20dried%20blood%20spots&rft.jtitle=Pharmacotherapy&rft.au=Saderup,%20Austin%20M.&rft.date=2021-03&rft.volume=41&rft.issue=3&rft.spage=291&rft.epage=298&rft.pages=291-298&rft.issn=0277-0008&rft.eissn=1875-9114&rft_id=info:doi/10.1002/phar.2490&rft_dat=%3Cproquest_pubme%3E2490605849%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2498911683&rft_id=info:pmid/33594735&rfr_iscdi=true |