Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 10;17(1):57.
doi: 10.1186/s12981-020-00313-z.

Returning of antiretroviral medication dispensed over a period of 8 months suggests non-adherence despite full adherence according to real time medication monitoring

Kennedy Michael Ngowi  1   2 , Lydia Masika  3 , Furaha Lyamuya  3   4 , Eva Muro  3   4 , Blandina T Mmbaga  5   3   4 , Mirjam A G Sprangers  6 , Pythia T Nieuwkerk  6 , Rob E Aarnoutse  7 , Peter Reiss  8   9 , I Marion Sumari-de Boer  5   10
Affiliations

Returning of antiretroviral medication dispensed over a period of 8 months suggests non-adherence despite full adherence according to real time medication monitoring

Kennedy Michael Ngowi et al. AIDS Res Ther. .

Abstract

Real-time medication monitoring (RTMM) may potentially enhance adherence to antiretroviral treatment (ART). We describe a participant in an ongoing trial who, shortly after completing trial participation, died of cryptococcal meningitis despite high levels of adherence according to self-report, pill-counts and RTMM (> 99%). However, she evidenced consistently high HIV viral load throughout the 48-week study follow-up. Subsequently, her relatives unsolicitedly returned eight months' dispensed ART medication that she was supposed to have taken. This brief report illustrates the challenges of adherence measurements including RTMM, and reinforces the need to combine adherence assessments with viral load monitoring in HIV care.

Keywords: ART; Adherence; Case report; Realtime medication monitoring; mHealth.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests. All authors have read and approved the final manuscript.

Figures

Fig. 1
Fig. 1
Adherence graphs (X-axis is the day of the month, Y-axis is the time of intake whereby the dots display the opening of the pillbox and the bars show the agreed time of intake)
Fig. 2
Fig. 2
a First-line Medication that was returned by relatives of our trial participant. b Second-line Medication that was returned by relatives of our trial participant
See this image and copyright information in PMC

References

    1. Bangsberg DR. Less Than 95% Adherence to Nonnucleoside Reverse-Transcriptase Inhibitor Therapy Can Lead to Viral Suppression. Clin Infect Dis. 2006;43(7):939–41. doi: 10.1086/507526. - DOI - PubMed
    1. Sumari-de Boer IM, Ngowi KM, Pima FM, Mmbaga BT, Nieuwkerk PT AR. Pharmacy Refill Counts and Self-reported Adherence Overestimate Adherence to Antiretroviral Treatment among People Living with HIV in Kilimanjaro, Tanzania. In: Poster sessions. Rwanda; 2019.
    1. Montgomery ET, Mensch B, Musara P, Hartmann M, Woeber K, Etima J, et al. Misreporting of product adherence in the MTN-003/VOICE Trial for HIV Prevention in Africa: Participants’ Explanations for Dishonesty. AIDS Behav. 2017;21(2):481–91. doi: 10.1007/s10461-016-1609-1. - DOI - PMC - PubMed
    1. Corneli AL, McKenna K, Perry B, Ahmed K, Agot K, Malamatsho F, et al. The Science of Being a Study Participant: FEM-PrEP Participants’ Explanations for Overreporting Adherence to the Study Pills and for the Whereabouts of Unused Pills. JAIDS J Acquir Immune Defic Syndr. 2015;68(5). https://journals.lww.com/jaids/Fulltext/2015/04150/The_Science_of_Being_... - PubMed
    1. Vrijens B, Tousset E, Rode R, Bertz R, Mayer S, Urquhart J. Successful projection of the time course of drug concentration in plasma during a 1-year period from electronically compiled dosing-time data used as input to individually parameterized pharmacokinetic models. J Clin Pharmacol. 2005;45(4):461–467. doi: 10.1177/0091270004274433. - DOI - PubMed

Publication types