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Determination of plasma drug concentration to estimate adherence is often not feasible but nevirapine plasma concentration may be useful and cost-effective in the setting of a pharmacovigilance program with adherence monitoring where this may be limited to patients at sentinel sites and at regular intervals.
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Although estimated adherence was good, measurements of PA can be improved by relatively simple imputation of missing AM data.
Finally, another limitation of the study is the fact that only one method of estimating adherence was used.
This means that the lower estimate of 23% adherence is a more likely estimate than the 41% based on more regular visitors.
These studies estimate that guideline adherence is between 80 and 100%%.
This estimate of adherence was calculated using the percentage of days covered (PDC) of 180 days post the clinical encounter with their clinician, defined as the number of days a patient had a supply of each medication divided by the number of days of eligibility for that medication.
Previous studies have shown that physicians' estimate of patient's adherence is far from being realistic (30).
However, when medication adherence is estimated from e.g. pharmacy claims databases, the estimates are substantially inflated as non-adherence and early non-persistent patients are largely not included in the estimations [ 55].
Moreover, estimates of adherence were close to maximal in both groups as has been found elsewhere [ 17, 27].
Another way to measure adherence is to estimate persistence, which is defined as the duration of time from initiation to discontinuation of therapy (8 19).
Multiple measures of adherence were used to estimate adherence behavior, and all suggest adherence is in the range needed for treatment success.
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