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Abstract：
BACKGROUND: Given the critical importance of medication adherence in HIV/AIDS treatment, this study aims to compare medication adherence measured by self-report (SR) and indirect measurement among antiretroviral therapy (ART) patients, exploring the differences of adherence results measured by different tools.
METHODS: We systematically searched PubMed, Embase, and the Cochrane Library to identify all relevant literature published up to November 22, 2023, without language restrictions, reporting adherence to ART measured by both SR and indirect measurement methods, while also analyzing individual and group adherence separately. Discrepancies between SR and indirect measurement results were assessed using the Mann-Whitney U test or Wilcoxon signed-rank test, with correlations evaluated using the Pearson correlation coefficient. Following one-to-one comparisons, meta-epidemiological one-step analysis was conducted, and network meta-analysis techniques were applied to compare results obtained through specific adherence assessment tools reported in the identified articles.
RESULTS: The analysis encompassed 65 original studies involving 13,667 HIV/AIDS patients, leading to 112 one-to-one comparisons between SR and indirect measurement tools. Statistically significant differences were observed between SR and indirect measurement tools regarding both individual and group adherence (P < 0.05), with Pearson correlation coefficients of 0.843 for individual adherence and 0.684 for group adherence. During meta-epidemiological one-step analysis, SR-measured adherence was determined to be 3.94% (95% CI: -4.48-13.44%) higher for individual adherence and 16.14% (95% CI: 0.81-18.84%) higher for group adherence compared to indirectly measured results. Subgroup analysis indicated that factors such as the year of reporting and geographic region appeared to influence the discrepancies between SR and indirect measurements. Furthermore, network meta-analysis revealed that for both individual and group adherence, the results obtained from most SR and indirect measurement tools were higher than those from electronic monitoring devices, with some demonstrating statistical significance (P < 0.05).
CONCLUSIONS: The findings underscored the complexity of accurately measuring medication adherence among ART patients. Significant variability was observed across studies, with self-report methods showing a significant tendency towards overestimation. Year of reporting, geographic region, and adherence measurement tools appeared to influence the differences between SR and indirect measurements. Future research should focus on developing and validating integrated adherence measurements that can combine SR data with indirect measures to achieve a more comprehensive understanding of adherence behaviors.
METHODS: We systematically searched PubMed, Embase, and the Cochrane Library to identify all relevant literature published up to November 22, 2023, without language restrictions, reporting adherence to ART measured by both SR and indirect measurement methods, while also analyzing individual and group adherence separately. Discrepancies between SR and indirect measurement results were assessed using the Mann-Whitney U test or Wilcoxon signed-rank test, with correlations evaluated using the Pearson correlation coefficient. Following one-to-one comparisons, meta-epidemiological one-step analysis was conducted, and network meta-analysis techniques were applied to compare results obtained through specific adherence assessment tools reported in the identified articles.
RESULTS: The analysis encompassed 65 original studies involving 13,667 HIV/AIDS patients, leading to 112 one-to-one comparisons between SR and indirect measurement tools. Statistically significant differences were observed between SR and indirect measurement tools regarding both individual and group adherence (P < 0.05), with Pearson correlation coefficients of 0.843 for individual adherence and 0.684 for group adherence. During meta-epidemiological one-step analysis, SR-measured adherence was determined to be 3.94% (95% CI: -4.48-13.44%) higher for individual adherence and 16.14% (95% CI: 0.81-18.84%) higher for group adherence compared to indirectly measured results. Subgroup analysis indicated that factors such as the year of reporting and geographic region appeared to influence the discrepancies between SR and indirect measurements. Furthermore, network meta-analysis revealed that for both individual and group adherence, the results obtained from most SR and indirect measurement tools were higher than those from electronic monitoring devices, with some demonstrating statistical significance (P < 0.05).
CONCLUSIONS: The findings underscored the complexity of accurately measuring medication adherence among ART patients. Significant variability was observed across studies, with self-report methods showing a significant tendency towards overestimation. Year of reporting, geographic region, and adherence measurement tools appeared to influence the differences between SR and indirect measurements. Future research should focus on developing and validating integrated adherence measurements that can combine SR data with indirect measures to achieve a more comprehensive understanding of adherence behaviors.
摘要：
背景：鉴于药物依从性在HIV/AIDS治疗中的重要性，这项研究旨在比较抗逆转录病毒治疗（ART）患者中通过自我报告（SR）和间接测量测量的药物依从性，探索不同工具测量的依从性结果的差异。
方法：我们系统地搜索了PubMed，Embase,和Cochrane图书馆，以确定截至2023年11月22日出版的所有相关文献，没有语言限制，报告通过SR和间接测量方法测量的ART依从性，同时还分别分析个人和团体的依从性。使用Mann-WhitneyU检验或Wilcoxon符号秩检验评估SR和间接测量结果之间的差异。与使用皮尔逊相关系数评估的相关性。在一对一比较之后，进行了元流行病学一步分析，和网络荟萃分析技术用于比较通过已确定文章中报告的特定依从性评估工具获得的结果.
结果：分析包括65项原始研究，涉及13,667名HIV/AIDS患者，导致SR和间接测量工具之间的112个一对一比较。SR和间接测量工具在个体和群体依从性方面的差异均具有统计学意义（P<0.05）。个体依从性的Pearson相关系数为0.843，团体依从性为0.684。在元流行病学一步分析中，与间接测量的结果相比，SR测量的依从性被确定为个体依从性高3.94％（95％CI：-4.48-13.44％），组依从性高16.14％（95％CI：0.81-18.84％）。亚组分析表明，报告年份和地理区域等因素似乎会影响SR和间接测量之间的差异。此外，网络荟萃分析显示，对于个人和团体的依从性，从大多数SR和间接测量工具获得的结果高于从电子监测设备获得的结果，具有统计学意义(P<0.05)。
结论：这些发现强调了准确测量ART患者药物依从性的复杂性。在研究中观察到显著的变异性，自我报告方法显示出明显的高估趋势。报告年份,地理区域,和依从性测量工具似乎影响SR和间接测量之间的差异。未来的研究应侧重于开发和验证综合依从性测量，可以将SR数据与间接测量相结合，以更全面地了解依从性行为。
方法：我们系统地搜索了PubMed，Embase,和Cochrane图书馆，以确定截至2023年11月22日出版的所有相关文献，没有语言限制，报告通过SR和间接测量方法测量的ART依从性，同时还分别分析个人和团体的依从性。使用Mann-WhitneyU检验或Wilcoxon符号秩检验评估SR和间接测量结果之间的差异。与使用皮尔逊相关系数评估的相关性。在一对一比较之后，进行了元流行病学一步分析，和网络荟萃分析技术用于比较通过已确定文章中报告的特定依从性评估工具获得的结果.
结果：分析包括65项原始研究，涉及13,667名HIV/AIDS患者，导致SR和间接测量工具之间的112个一对一比较。SR和间接测量工具在个体和群体依从性方面的差异均具有统计学意义（P<0.05）。个体依从性的Pearson相关系数为0.843，团体依从性为0.684。在元流行病学一步分析中，与间接测量的结果相比，SR测量的依从性被确定为个体依从性高3.94％（95％CI：-4.48-13.44％），组依从性高16.14％（95％CI：0.81-18.84％）。亚组分析表明，报告年份和地理区域等因素似乎会影响SR和间接测量之间的差异。此外，网络荟萃分析显示，对于个人和团体的依从性，从大多数SR和间接测量工具获得的结果高于从电子监测设备获得的结果，具有统计学意义(P<0.05)。
结论：这些发现强调了准确测量ART患者药物依从性的复杂性。在研究中观察到显著的变异性，自我报告方法显示出明显的高估趋势。报告年份,地理区域,和依从性测量工具似乎影响SR和间接测量之间的差异。未来的研究应侧重于开发和验证综合依从性测量，可以将SR数据与间接测量相结合，以更全面地了解依从性行为。
