Visual analogue scale (VAS) measurement of antiretroviral adherence in people living with HIV (PLWH): a meta-analysis
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Effective treatment of HIV hinges upon maintaining adequate antiretroviral therapy adherence. Accurate, cost-effective measurement of medication adherence is needed to best respond to the HIV pandemic. The visual analogue scale (VAS) appears to be a simple and easy to use measure of adherence but the current literature on its use is mixed. This meta-analysis (1) describes VAS concordance with other measures of medication adherence and viral load; and (2) examines how research methods moderate the reported strength of the VAS–viral load relationship. Literature searches were conducted electronically and by hand with a total of 20 studies included in the present study. The VAS showed large strength associations with most other measures of adherence and a smaller association with viral load. More rigorous methodological quality significantly improved the VAS–viral load effect size. We conclude with optimization recommendations for VAS use in clinical practice and research design.
KeywordsHIV Medication adherence Visual analogue scale Viral load Adherence measurement Meta-analysis Methodological quality mHealth
This research was supported by U.S. Public Health Service Institutional National Research Service Award T32-MH074387 (PI: Seth C. Kalichman; trainees: David J. Finitsis and Jennifer A. Pellowski). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
David J. Finitsis, Jennifer A. Pellowski, Tania B. Huedo-Medina, Matthew C. Fox and Seth C. Kalichman declare that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
- Abioye, A. I., Siope, A., Salako, A. A., Odesanya, M. O., Okuneye, T. A., Abioye, A. I., et al. (2015). Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts. AIDS Care, 27, 1468–1486. doi: 10.1080/09540121.2015.1114994 CrossRefPubMedGoogle Scholar
- Assoumou, L., Descamps, D., Yerly, S., Dos Santos, G., Marcelin, A. G., Delaugerre, C., et al. (2013). Prevalence of HIV-1 drug resistance in treated patients with viral load > 50 copies/mL in 2009: A French nationwide study. Journal of Antimicrobial Chemotherapy. doi: 10.1093/jac/dkt033 Google Scholar
- Brinkel, J., Krämer, A., Krumkamp, R., May, J., & Fobil, J. (2014). Mobile phone-based mHealth approaches for public health surveillance in sub-Saharan Africa: A systematic review. International Journal of Environmental Resources and Public Health, 11, 11559–11582. doi: 10.3390/ijerph111111559 CrossRefGoogle Scholar
- Card, N. (2012). Applied meta-analysis for social science research. New York: The Guilford Press.Google Scholar
- Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
- Cooper, H. M., & Hedges, L. V. (Eds.). (1994). The handbook of research synthesis and meta-analysis (2nd ed.). New York, NY: Russell Sage.Google Scholar
- Do, H. M., Dunne, M. P., Kato, M., Pham, C. V., & Nguyen, K. V. (2013). Factors associated with suboptimal adherence to antiretroviral therapy in Viet Nam: A cross-sectional study using audio computer-assisted self-interview (ACASI). BMC Infectious Diseases, 13, 154.CrossRefPubMedPubMedCentralGoogle Scholar
- Feldman, B. J., Fredericksen, R. J., Crane, P. K., Safren, S. A., Mugavero, M. J., Willig, J. H., et al. (2013). Evaluation of the single-itme self-rating adherence scale for use in routine clinical care of people living with HIV. AIDS and Behavior, 17, 307–318. doi: 10.1007/s10461-012-0326-7 CrossRefPubMedPubMedCentralGoogle Scholar
- Ferreira, J. L., Rodrigues, R., Lanca, A. M., Correia de Almeida, V., Rocha, S. Q., Ragazzo, T. G., et al. (2013). Transmitted drug resistance among people living with HIV/AIDS at major cities of Sao Paulo State, Brazil. Advances in Virology, published online. Retrieved from doi: 10.1155/2013/878237
- Friedman, S. R., de Jong, W., Rossi, D., Touze, G., Rockwell, R., Des Jarlais, D. C., & Elovich, R. (2007). Harm reduction theory: Users culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups. International Journal of Drug Policy, 18(2), 107–117.CrossRefPubMedGoogle Scholar
- Furberg, R. D., Uhrig, J. D., Bann, C. M., Lewis, M. A., Harris, J. L., Williams, P., et al. (2012). Technical implementation of a multi-component, text message-based intervention for persons living with HIV. Journal of Medical Internet Research Protocols, 16(1), e17. doi: 10.2196/resprot.2017 CrossRefGoogle Scholar
- Gionatti, N., Galli, L., Bocchiola, B., Cahua, T. R., Panzini, P., Zandona, D., et al. (2013). Number of daily pills, dosing schedule, self-reported adherence and health status in 2010: A large cross-sectional study of HIV-infected patients on antiretroviral therapy. HIV Medicine, 14, 153–160.CrossRefGoogle Scholar
- Gleser, L. J., & Olkin, I. (1994). Stochastically dependent effect sizes. The Handbook of Research Synthesis and Meta-Analysis (2nd ed., pp. 357–377). New York: Russell Sage.Google Scholar
- Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. San Diego, CA: Academic Press.Google Scholar
- Higgins, J. P., & Green, S. (Eds.) (2011). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org
- Hong, S. Y., Jerger, L., Jonas, A., Badi, A., Cohen, S., Nachega, J. B., et al. (2013). Medication possession ratio associated with short-term virologic response in individuals initiating antiretroviral therapy in Namibia. PLoS One, 8, e56307. doi: 10.1371/journal.pone.0056307 CrossRefPubMedPubMedCentralGoogle Scholar
- Hugen, P. W., Langebeek, M., Burger, D. M., Zomer, B., van Leusen, R., Schuurman, R., et al. (2002). Assessment of adherence to HIV protease inhibitors: Comparison and combination of various methods, including MEMS (electronic monitoring), patient and nurse report, and therapeutic drug monitoring. Journal of Acquired Immune Deficiency Symdromes, 30, 324–334.CrossRefGoogle Scholar
- Kalichman, S. C., Amaral, C. M., Swetzes, C., Jones, M., Macy, R., Kalichman, M. O., et al. (2009). A simple single-item rating scale to measure medication adherence: Further evidence for convergent validity. Journal of the International Association of Physicians in AIDS Care, 8, 367–374. doi: 10.1177/1545109709352884 CrossRefPubMedGoogle Scholar
- Maldonado-Martinez, G., Hunter-Mellado, R. F., Fernandez-Santos, D., & Rios-Olivares, E. (2016). Persistent HIV viremia: Description of a cohort of HIV infected individuals with ART failure in Puerto Rico. International Journal of Environmental Research and Public Health, 13, 50. doi: 10.3390/ijerph13010050 CrossRefGoogle Scholar
- Mbuagbaw, L., Thabane, L., Ongolo-Zogo, P., Lester, R. T., Mills, E. J., Smieja, M., et al. (2012). The cameroon mobile phone SMS (CAMPS) trial: A randomized trial of text messaging versus usual care for adherence to antiretroviral therapy. PLoS One, 7, e46909. doi: 10.1371/journal.pone.0046909 CrossRefPubMedPubMedCentralGoogle Scholar
- Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med: Available: e1000097. doi: 10.1371/journal.pmed1000097. Accessed 5 June 2013.
- Muessig, K., Nekkanti, M., Bauermeister, J., Bull, S., & Hightow-Weidman, L. (2015). A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Current HIV/AIDS Reports, 12, 173. doi: 10.1007/s11904-014-0239-3 CrossRefPubMedPubMedCentralGoogle Scholar
- National Institute for Health and Care Excellence. (2012). Appendix G Quality appraisal checklist: Quantitative studies reporting correlations and associations. In Methods for the development of NICE public health guidance, 3rd edn. http://www.nice.org.uk/article/pmg4/chapter/appendix-g-quality-appraisal-checklist-quantitative-studies-reporting-correlations-and-associations
- Oyugi, J. H., Byakika-Tusiime, J., Charlebois, E. D., Kityo, C., Mugerwa, R., Mugyenyi, P., et al. (2004). Multiple validated measures of adherence indicate high levels of adherence to generic HIV antiretroviral therapy in a resource-limited setting. Journal of Acquired Immune Deficiency Syndromes, 36, 1100–1102.CrossRefPubMedGoogle Scholar
- Peltzer, K., Friend-du Preez, N., Ramlagan, S., & Anderson, J. (2010). Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa. BMC Public Health. Retrieved online from http://www.biomedcentral.com/1471-2458/10/111
- IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Google Scholar
- Segeral, O., Madec, Y., Ban, B., Ouk, V., Hak, C. R., Le Tiec, C., et al. (2010). Simplified assessment of antiretroviral adherence and prediction of virological efficacy in HIV-infected patients in Cambodia. AIDS Research and Treatment, 2010, 142076. doi: 10.1155/2010/142076 CrossRefPubMedGoogle Scholar
- Sinha, S., Ahmad, H., Shekhar, R. C., Kumar, N., Dar, L., Samantaray, J. C., et al. (2012). Prevalence of HIV drug resistance mutations in HIV type 1 isolates in antiretroviral therapy naive population from northern India. AIDS Research and Treatment, 2012, 905823. doi: 10.1155/2012/905823 CrossRefPubMedPubMedCentralGoogle Scholar
- Treiblmaier, H., & Filzmoser P. (2009). Benefits from using continuous rating scales in online survey research. In Proceedings of the Institut f. Statistik u. Wahrscheinlichkeitstheorie, Forschungsbericht SM-2009-4, November 2009.Google Scholar
- Viechtbauer, W. (2010). Conducting meta-analyses in R with the metafor package. Journal of Statistical Software, 36, 1–48. http://www.jstatsoft.org/v36/i03/
- Wilson, D. B. (2002). Meta-analysis macros for SAS, SPSS, and Stata [Computer Software]. Available: http://mason.gmu.edu/~dwilsonb/ma.html. Accessed 7 April 2012.
- World Health Organization. (2006). Working together for health: The world health report. Geneva: WHO Press.Google Scholar
- World Health Organization. (2012). Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: Recommendations for use in the context of demonstration projects. Geneva, Switzerland: WHO Document Production Services.Google Scholar