Abstract
This study assessed the frequency of neuropsychological impairment and its relationship to adherence in a sample of HIV-infected injection drug users (IDUs) in treatment. One hundred eight participants recruited between September 2006 and October 2008 completed psychodiagnostic and neuropsychological assessments and monitored HAART adherence over a 2-week period via the use of Medication Event Monitoring System (MEMS) electronic pill caps and self-report. Assessment of concurrent functioning included clinician-rated scales of depression and substance use severity, and a battery of neuropsychological tests. Findings from individual neuropsychological tests were converted to Z scores relative to standard norms and averaged to form a composite score (NPZ). NPZ was generally poor (mean/-1.505, standard deviation/1.120), with 76.9% of the sample being classified as highly impaired. Self-reported adherence was significantly higher than MEMS cap adherence. In contrast with previous studies, overall neuropsych logical functioning was not a significant predictor of electronically monitored or self-reported adherence. However, examiner-rated current global severity of substance use and delayed word list recall emerged as significant predictors of self-reported adherence. Additionally, estimated premorbid verbal intelligence emerged as a significant predictor of the discrepancy between electronically monitored and self-reported adherence. Given the extent of neuropsychological impairment in this sample, future studies should examine the degree to which the impact of neuropsychological impairment may moderate interventions for this population, and the extent to which skills to cope with neuropsychological problems may boost the potential efficacy of such interventions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 455-462 |
| Number of pages | 8 |
| Journal | AIDS Patient Care and STDs |
| Volume | 23 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2009 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
Cite this
The impact of neuropsychological functioning on adherence to HAART in HIV-infected substance abuse patients. / Applebaum, Allison J.; Reilly, Laura C.; Gonzalez, Jeffrey S.; Richardson, Mark A.; Leveroni, Catherine L.; Safren, Steven.
In: AIDS Patient Care and STDs, Vol. 23, No. 6, 01.06.2009, p. 455-462.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The impact of neuropsychological functioning on adherence to HAART in HIV-infected substance abuse patients
AU - Applebaum, Allison J.
AU - Reilly, Laura C.
AU - Gonzalez, Jeffrey S.
AU - Richardson, Mark A.
AU - Leveroni, Catherine L.
AU - Safren, Steven
PY - 2009/6/1
Y1 - 2009/6/1
N2 - This study assessed the frequency of neuropsychological impairment and its relationship to adherence in a sample of HIV-infected injection drug users (IDUs) in treatment. One hundred eight participants recruited between September 2006 and October 2008 completed psychodiagnostic and neuropsychological assessments and monitored HAART adherence over a 2-week period via the use of Medication Event Monitoring System (MEMS) electronic pill caps and self-report. Assessment of concurrent functioning included clinician-rated scales of depression and substance use severity, and a battery of neuropsychological tests. Findings from individual neuropsychological tests were converted to Z scores relative to standard norms and averaged to form a composite score (NPZ). NPZ was generally poor (mean/-1.505, standard deviation/1.120), with 76.9% of the sample being classified as highly impaired. Self-reported adherence was significantly higher than MEMS cap adherence. In contrast with previous studies, overall neuropsych logical functioning was not a significant predictor of electronically monitored or self-reported adherence. However, examiner-rated current global severity of substance use and delayed word list recall emerged as significant predictors of self-reported adherence. Additionally, estimated premorbid verbal intelligence emerged as a significant predictor of the discrepancy between electronically monitored and self-reported adherence. Given the extent of neuropsychological impairment in this sample, future studies should examine the degree to which the impact of neuropsychological impairment may moderate interventions for this population, and the extent to which skills to cope with neuropsychological problems may boost the potential efficacy of such interventions.
AB - This study assessed the frequency of neuropsychological impairment and its relationship to adherence in a sample of HIV-infected injection drug users (IDUs) in treatment. One hundred eight participants recruited between September 2006 and October 2008 completed psychodiagnostic and neuropsychological assessments and monitored HAART adherence over a 2-week period via the use of Medication Event Monitoring System (MEMS) electronic pill caps and self-report. Assessment of concurrent functioning included clinician-rated scales of depression and substance use severity, and a battery of neuropsychological tests. Findings from individual neuropsychological tests were converted to Z scores relative to standard norms and averaged to form a composite score (NPZ). NPZ was generally poor (mean/-1.505, standard deviation/1.120), with 76.9% of the sample being classified as highly impaired. Self-reported adherence was significantly higher than MEMS cap adherence. In contrast with previous studies, overall neuropsych logical functioning was not a significant predictor of electronically monitored or self-reported adherence. However, examiner-rated current global severity of substance use and delayed word list recall emerged as significant predictors of self-reported adherence. Additionally, estimated premorbid verbal intelligence emerged as a significant predictor of the discrepancy between electronically monitored and self-reported adherence. Given the extent of neuropsychological impairment in this sample, future studies should examine the degree to which the impact of neuropsychological impairment may moderate interventions for this population, and the extent to which skills to cope with neuropsychological problems may boost the potential efficacy of such interventions.
UR - http://www.scopus.com/inward/record.url?scp=67651174414&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67651174414&partnerID=8YFLogxK
U2 - 10.1089/apc.2008.0181
DO - 10.1089/apc.2008.0181
M3 - Article
C2 - 19519229
AN - SCOPUS:67651174414
VL - 23
SP - 455
EP - 462
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
SN - 1087-2914
IS - 6
ER -