9, 13, 14, 15, 16, 17 and 18 Other commonly used methods include pill counts, records of pharmacy Apoptosis inhibitor visits, medication diaries, electronic devices such as Medication Event Monitoring System (MEMS) (MWV Healthcare, Sion, Switzerland) caps, and therapeutic drug monitoring. A systematic literature review on adherence evaluation, which included 176 studies, demonstrated the use of a single method in most studies; in 71%, self-administered questionnaires

were the method of choice.19 Many studies involving HIV-infected patients using of cART have found good association between viral suppression and adherence scale scores, including validated scales assessing self-reported missed doses.14, 15, 20 and 21 However,

the present results corroborate those of Mellins et al.15 and Allison et al.,21 presenting findings from studies conducted in the United States. These two studies did not demonstrate significant associations between reported missed doses of ART in the last days and viral suppression. A meta-analysis on the association between adherence to cART and viral suppression among children, adolescents, and young adults found that this relationship was stronger for longitudinal studies when compared to cross-sectional studies, and that this association tended to be weaker (or absent) when the informant was the caregiver.22 In the present study, “no missed cART doses Ceritinib research buy in the last three days”, as reported by patients/caregivers, was found to be associated with improved quality of life of caregivers, low anxiety scores, as well as the context and timing of HIV diagnosis, with better adherence found among those diagnosed by family screening. Most of these findings are in accordance with previous

pediatric studies. In 2004, Mellins et al. interviewed 75 caregivers in the United States about their children’s ART missed doses in the last month and observed that non-adherence was associated with worse parent-child communication, higher levels of stress, and lower quality of life among caregivers, as well as poor cognitive functioning and less open this website disclosure of caregivers’ HIV status to others.15 A systematic review on adherence to cART versus quality of life among adults living with HIV identified 12 studies, most of them aiming to evaluate how adherence has been associated with quality of life as a treatment outcome. 23 Different results suggest that a virtuous cycle may exist, with optimal adherence and a high quality of life boosting each other through a feedback loop. Anxiety has been previously identified as a predictor of non-adherence among HIV-infected adults. A comprehensive survey implemented in the United States on behalf of the HIV Cost and Services Utilization Study found anxiety disorder, depression, and drug use as key risk factors for non-adherence.