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Validation of the Special Projects of National Significance adherence tool in HIV/AIDS patients
Frank S Julian1, Patty Martin, Steven R Erickson
1Sinai-Grace Hospital, Detroit, MI 48235, USA. fjulian@dmc.org
Insights
The SPNS survey effectively measures adherence to highly active antiretroviral therapy (HAART), showing a strong correlation between adherence scores and lower viral loads in HIV/AIDS patients. This simple tool aids healthcare professionals in assessing patient adherence.
Area of Science:
- Medical Science
- Infectious Diseases
- Public Health
Background:
- Adherence to highly active antiretroviral therapy (HAART) is critical for successful HIV/AIDS management.
- Validated tools are needed to accurately assess patient adherence to HAART.
- The Health Resources and Services Administration developed a 3-question survey (SPNS) to assess adherence in HIV/AIDS patients.
Purpose of the Study:
- To validate the SPNS adherence survey for accuracy and effectiveness in assessing HAART adherence.
- To identify independent variables correlating with significant reductions in viral load.
Main Methods:
- Retrospective chart review of 300 patients with HIV/AIDS enrolled in a clinic from January to September 2007.
- Inclusion criteria: HAART for ≥6 months, age ≥18 years, and completion of at least 2 surveys.
- Analysis of 74 eligible patients' adherence scores and viral load data.
Main Results:
- Patients with adherence scores ≤10 (poorer adherence) had significantly higher average viral loads (15,202.3 copies/mL) compared to those with scores ≥11 (adherent) (163.8 copies/mL).
- The SPNS adherence score was significantly associated with HIV-RNA viral load (p < 0.001).
- Higher viral loads correlated with taking more medications and different antiretroviral formulations, but not age, sex, race, income, or dosing frequency.
Conclusions:
- The SPNS survey is a valid and simple tool for measuring HAART adherence.
- This survey can assist healthcare professionals in assessing and improving patient adherence to HIV/AIDS treatment regimens.
Background:
Adherence to highly active antiretroviral therapy (HAART) is crucial for success. Therefore, having validated tools to help assess adherence is necessary. The Health Resources and Services Administration assessed adherence as a Special Project of National Significance (SPNS). As a result of their study, a 3-question survey was developed as a simple tool to assess adherence in patients with HIV/AIDS.
Objective:
To validate the SPNS adherence survey as an accurate and effective way to assess adherence and to determine whether any other independent variables correlate with a significant reduction in viral load.
Methods:
The study was a retrospective chart review of 300 patients actively enrolled in an HIV/AIDS clinic from January 2007 to September 2007. Patients were eligible for the study if they had been on HAART for at least 6 months, were > or =18 years old, and had completed at least 2 surveys.
Results:
A total of 74 patients met the criteria; the majority were male (75.3%) and African American (91.9%). Twenty-six (35.1%) patients had scores < or =10, indicating poorer adherence, and 48 (64.9%) patients had scores > or =11. The mean number of antiviral plus other medications was 4.4. Dosing of HAART drugs was once (5 nonadherent, 23 adherent pts.) and twice (21, 25 pts., respectively) daily, and mean number of different antiretroviral tablets/capsules being taken was 1.7 and 1.5, respectively. The nonadherent patients' average viral load was 15,202.3 copies/mL, while the adherent patients' average viral load was 163.8 copies/mL (p = 0.001) The SPNS score was significantly associated with HIV-RNA viral load (-0.482, p < 0.001). There also was a significant association between a higher HIV-RNA viral load and the total number of medications a patient was taking, as well as the number of different antiretroviral tablets/capsules being taken (0.299, p = 0.01; 0.249, p = 0.03). There was no significant difference in HIV-RNA viral load when comparing age, sex, race, income, and frequency of HIV drug dosing.
Conclusions:
The SPNS survey is a valid and simple tool in measuring adherence that can aid health-care professionals in assessing adherence to HAART.
