Pill counts with calculated adherence percentages are used in many settings to monitor adherence, but can be undermined by patients discarding pills to hide non-adherence.
Pill counts suggesting that >100% of prescribed doses were taken can signal "pill dumping." We defined "over-adherence" (OA) among a cohort of 300 HIV-infected adolescents as having >1/3 of pill counts with >100% adherence during a year of follow-up. Apparent over-adherence was more common in those with virologic failure than those with suppressed viral loads (33% vs 13%, chi p=0.001).
Pill count adherence repeatedly >100% may identify HIV-infected adolescents at increased risk of treatment failure.
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By: Okatch H1, Beiter K, Eby J, Chapman J, Marukutira T, Tshume O, Matshaba M, Anabwani GM, Gross R, Lowenthal E.
- 1Children's Hospital of Philadelphia, Philadelphia, PA, USA
- 2 University of Pennsylvania Perelman School of Medicine, Masters of Public Health Program, Philadelphia, PA, USA
- 3 University of Botswana, Gaborone, Botswana
- 4 Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
- 5 Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, TX, USA
- 6 University of Pennsylvania Perelman School of Medicine, Departments of Medicine and Epidemiology, Philadelphia, PA, USA
- 7 University of Pennsylvania Perelman School of Medicine, Departments of Pediatrics and Epidemiology, Philadelphia, PA, USA.
- J Acquir Immune Defic Syndr. 2016 Mar 16
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