开发和验证一种风险评分,用于预测抗逆转录病毒疗法不遵守的情况
Pablo Acin1, Sonia Luque2, Isaac Subirana3
1Pharmacy Service Colisée Barcelona Isabel Roig, Barcelona, Spain.
AIDS research and human retroviruses
|June 9, 2023
概括
一个新的得分预测了开始治疗的人对抗逆转录病毒疗法 (ART) 的不坚持. 这种工具可以识别高风险的患者,从而为艾滋病毒管理提供更好的资源配置和治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 已知影响抗逆转录病毒治疗 (ART) 坚持的患者相关因素.
- 然而,缺乏简单的工具来预测ART启动后的不坚持.
研究的目的:
- 开发和验证在开始ART的个体中不遵守的预测得分.
- 确定不遵守的关键预测因素,以指导早期干预策略.
主要方法:
- 一个预测得分被开发和验证使用两个队列的患者启动ART.
- 后勤回归确定了不坚持的预测因素;使用β系数创建了一个得分.
- 通过药房补充和自我报告来评估遵守;不遵守被定义为<90%的剂量或>1周的中断.
主要成果:
- 该得分是使用349名患者开发的,并对225名患者进行了验证,在衍生队列中,不遵守的比例为29.8%.
- 关键预测因素包括偏见,失败的约会,文化障碍,药物滥用,住房不稳定和严重的精神疾病.
- 该得分获得了高准确度 (C统计值0.91),最佳切割距离为26.3 (灵敏度0.87,特异性0.86).
结论:
- 开发了一个易于使用,高度敏感和特定的工具来预测ART不坚持风险.
- 这个分数可以识别高风险患者,优化资源配置,改善治疗结果.
- 验证的分数提供了一种实际的方法,以提高对艾滋病毒管理的遵守.
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