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Journal of Pediatric Psychology Advance Access originally published online on March 2, 2006
Journal of Pediatric Psychology 2006 31(9):989-994; doi:10.1093/jpepsy/jsj107
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org

Brief Report: Assessing Adherence to Pediatric Antiretroviral Regimens Using the 24-Hour Recall Interview

Stephanie L. Marhefka, PhD1, Vicki J. Tepper, PhD2, John J. Farley, MD, MPH2, John W. Sleasman, MD3 and Claude Ann Mellins, PhD1

1 HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University of the City of New York, 2 Department of Pediatrics, University of Maryland School of Medicine, and 3 Department of Pediatrics, University of South Florida College of Medicine

All correspondence concerning this article should be addressed to Stephanie L. Marhefka, PhD, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, New York 10032. E-mail: sm2443{at}columbia.edu.

Received May 31, 2005; revision received November 18, 2005 and January 31, 2006; accepted February 9, 2006

Objective Examine the 24-hr Recall Interview (24RI) for assessing children’s antiretroviral medication adherence. Methods Caregivers of 54 children with HIV (aged 2–12 years) completed a clinical adherence interview and the 24RI by telephone. Children’s viral load and 3-month pharmacy records were obtained. Results Thirty-seven percent of children missed ≥1 dose of medicine over 3 days. In 22% of the samples, adherence varied across medications. The 24RI adherence scores (Frequency, Interval, and Dietary Adherence) were moderately reliable across the three interviews. Pharmacy refill rates were significantly related to viral load, and 24RI barriers were marginally significantly related to viral load. Conclusions The 24RI, with its systematic, cued recall, and decreased focus on adherence, may reduce socially desirable responding compared to other self-report methods, and reporting adherence barriers may indicate adherence difficulty. However, the validity of the 24RI must be improved to make it a useful measure to include in an adherence assessment battery.

Key words: antiretroviral therapy; HIV; patient adherence; patient compliance.


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