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11 Patients with an average MPR ≥80% were classed as adherent; this is in line with previous adherence studies conducted in IBD.
Similar to findings of other longitudinal adherence studies in CF and COPD [ 8, 12], participants who were adherent to inhaled antibiotics had fewer pulmonary exacerbations, with nearly twice as many exacerbations in the non-adherent group.
The congruence between adherence-related patient characteristics and interventions may partly explain the variability of effectiveness in medication adherence studies.
Methodological issues in measuring adherence are addressed and suggestions for improving the design of future adherence studies highlighted, of which there is a great need.
In most adherence studies, the percentage of missed doses during the last three or four days is usually the only aspect of adherence being assessed [21].
In early adherence studies, including unboosted protease inhibitors (PIs), a 95% adherence level was shown to be associated with high virologic suppression [51], a greater increase in CD4 cell count, and lower hospitalization rates [52], [53].
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For example, non-adherent patients may refuse to participate in an adherence study, resulting in over-estimation of medication adherence.
We would like to thank the following people for their support with various aspects of the adherence study: Margaret Chesney, Eric Goemaere, Catherine Orrell, and Colywn Poole.
Ethical approval for the parent trial CHAPAS-1 (Children with HIV in Africa – Pharmacokinetics and Adherence of Simple antiretroviral regimens, ISRCTN 31084535) and the adherence study was given by the University of Zambia and the University College, London.
Only one pediatric adherence study was indentified.
In adherence study, the majority of children were reported to have received all doses.
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