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Based on MEMS adherence records, mean adherence for the 30 days prior to the first and second pharmacokinetic study visits was 99.7% and 99.0%, respectively.
However, on exclusion of the 68 who had no adherence records, 90.4 % had good adherence recorded on their ART cards.
Also, as described previously and observed in this study, electronic adherence records would have been inaccurate had we not solved the device's clock malfunction (which required use of the log book self-reports).
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On exclusion of the 68 who had no records on adherence level, 90.4 % of those who had an adherence record had good adherence.
Out of 1824 adolescents who were active on ART, 90.4 % (N = 1588) had ≥95 % adherence recorded on their ART cards at their last clinic visit.
Overall, of the 1824 ALHIV, 87.1 % (N = 1588) had good adherence recorded on their ART cards at the last clinic visit.
Clearly, none of the methods used to measure adherence record actual intake of medication, and there are even indications that at least in some instances self-reporting is a more accurate record of adherence [ 24].
[ 13] A priori we hypothesized that the agreement between self-reported and electronically monitored adherence recording might differ by sex, age, number of months in the study, and cognition.
* F-test for inclusion of 3 coverage terms in model, p = 0.0465 ** F-test for inclusion of 2 self-report terms in model, p = 0.0316 & Models exclude cases from Ethiopia which assessed self-reported adherence differently Average self-reported adherence recorded in medical records up to the date of the second CD4 test had an overall significant relationship with CD4 gain.
The protocol specified that 10 minute sessions should occur daily; however, since the paper logs did not include the length of treatment, adherence recorded by the devices was defined as the number of sessions initiated relative to the number of possible sessions.
Perhaps if systems were simplified and integrated to ensure that patient weight is only recorded once then adherence to recording and documentation may increase.
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