Remor E, Milner-Moskovics J, Preussler G., 200728
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Translate, adapt and validate the questionnaire for use in Brazil: Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral (CEAT-VIH)”. It is a self-administered instrument to identify the degree of adherence to antiretroviral treatment in patients with HIV infection. |
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This methodological study was based on a questionnaire translated from the original Spanish into Portuguese, with a back translation process (Spanish/Portuguese/Spanish), and verbal evaluation of understanding with a small group of patients.
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The analysis of psychometric properties involved 59 patients on antiretroviral treatment from Porto Alegre, Rio Grande do Sul, Brazil. Internal consistency and external criterion-related validity, sensitivity and specificity supported validation. For the final version of the CEAT-VIH (20 questions), the total score is obtained by the sum of all items (minimum possible value 17, maximum possible value 89).
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Adequate reliability of the questionnaire (α = 0.64) and validity related to an external criterion (viral load; r = -0.48; p < 0.001) were observed. Also, adequate sensitivity (79.2%) and specificity (57.1%) of the questionnaire were observed for detection between individuals with undetectable and detectable viral load.
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The optimal cutoff point suggested by the analysis is ≥ 76. The values below indicate insufficient adherence to treatment, and association with a detectable viral load. This score is associated with a sensitivity of 79.2%, and specificity of 57.1%.
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1) Calculation for sample size is not presented.
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2) Study in only one institution, making generalization difficult; therefore, it is not a nationally representative study.
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3) The established cutoff point should be used with caution as the questionnaire is a self-administered instrument.
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4) Hawthorne’s effect.
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Costa LS, Latorre M do RD de O, Silva MH da, Bertolini DV, Machado DM, Pimentel SR, et al., 200829
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Validate a self-efficacy scale for adherence to antiretroviral treatment in children and adolescents with HIV/Aids, taking into account the perspective of parents/guardians, and evaluate its reproducibility. |
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Methodological study conducted at the Hospital-Dia do Centro de Referência e Treinamento em DST/Aids (Day Hospital of the STD/Aids Reference and Training Center) in São Paulo. We interviewed the parents/guardians of 54 children and adolescents of 6 months to 20 years of age who went through routine consultation at the service. The self-efficacy data of adherence to antiretroviral prescription was calculated in two ways: factor analysis, and pre-defined formula. The internal consistency of the scale was verified by Cronbach’s α coefficient.
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Validity was assessed by comparing the mean scores between groups of patients adherent and non-adherent to antiretroviral treatment (Mann-Whitney test), and calculation of Spearman’s correlation coefficient between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, the intraclass correlation coefficient, and Bland-Altman plots.
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The self-efficacy scale consists of 21 questions. It showed good internal consistency (α = 0.87), and good reproducibility (ICC = 0.69 and ICC = 0.75). As for validity, the self-efficacy scale for following antiretroviral prescription was able to discriminate patients with adherence and with insufficient adherence to antiretroviral treatment (p = 0.002), and showed significant correlation with CD4 count (r = 0.28; p = 0.04).
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Results are added with the fact that children/adolescents with adherence to antiretroviral treatment have higher expectancies of self-efficacy than those with insufficient adherence.
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The self-efficacy scale for following antiretroviral prescription can be used to assess adherence to antiretroviral therapy in children and adolescents with HIV/ Aids, taking into account the perspective of parents/caregivers.
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This is not a Nationally representative study.
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Parents/caregivers responded for the children/adolescents. The perception of the target population of the study was not considered.
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Hawthorne’s effect.
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Vale FC, Santa-Helena ET de, Santos MA, Carvalho WM do ES, Menezes PR, Basso CR, et al., 201830
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Present the development and validation of the WebAd-Q Questionnaire, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/Aids services in Brazil. |
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Methodological study. The WebAd-Q is an electronic questionnaire that contains three questions about taking antiretroviral drugs in the last week. It was constructed based on interviews and focus groups with 38 patients. Validity was verified in a study with a sample of 90 patients older than 18 years, on antiretroviral therapy for at least three months. The following comparative adherence measures were used: electronic monitoring, pill count, and self-report interview. The WebAd-Q was completed on day 6 twice, at least 1 hour apart.
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The viral load of patients was obtained from service records. Agreement between WebAd-Q responses, associations and correlations with viral load and performance against other measures of adherence were analyzed.
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Among guest patients, 74 (82.2%) responded to the WebAd-Q. No difficulties in answering the questionnaire were reported. The average response time was 5 min 47 sec.
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The set of the three WebAd-Q questions obtained 89.8% agreement, with a Kappa of 0.77 (95% CI 0.61-0.94).
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WebAd-Q insufficient adherence responses were associated with detectable viral load. Moderate correlations of viral load with insufficient adherence scale according to WebAd-Q were obtained. For all the three WebAd-Q questions, patients with responses of insufficient adherence were also noted as less adherent according to the other measures of adherence.
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The WebAd-Q met the main requirements for questionnaire validation, showed high participant comprehension and association with viral load, and obtained agreement and good performance compared to competing measures.
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This is not a Nationally representative study.
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Sample loss may have reduced the statistical power of the study.
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Hawthorne’s effect.
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