Abstract
Objective: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection. Methods: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors. Results: Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence. Conclusion: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 164-175 |
| Number of pages | 12 |
| Journal | Journal of Pediatric Psychology |
| Volume | 34 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 2009 |
Keywords
- Adolescents
- Children
- Cognitive functioning
- HIV
- Medication adherence
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Developmental and Educational Psychology
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The role of cognitive functioning in medication adherence of children and adolescents with HIV infection. / Malee, Kathleen; Williams, Paige L.; Montepiedra, Grace; Nichols, Sharon; Sirois, Patricia A.; Storm, Deborah; Farley, John; Kammerer, Betsy; Turcich, M.; Harris, L.; Iovino, I.; Usitalo, Ann; Rathore, Mobeen H.; Mirza, Ayesha; Mahmoudi, Saniyyah; Malee, K.; Cruz, C.; Scalley, Nydia; Khadivi, A.; Miranda, D.; Scott, G. B.; Mitchell, C. D.; Taybo, L.; Willumsen, S.; Adubato, Susan; Hanna, Jennis; Sirois, P.; Nichols, S.; Wilson, S.; Shaw, R.; Grant, Mitzie L.; Chen, Janet S.; Foster, Jill A.; McQuiston, Susan; Homans, J.; Neely, M.; Spencer, L. S.; Kovacs, A.; Kammerer, B.; Meade, J.; Rothermel, R.; Schuster, L.; Yumoto, C.; Miles, M.; Cooper, T.; Garvie, Patricia; Borkowsky, W.; Chandwani, S.; Deygoo, N.; Akleh, S.; Bewley, S.; Rohwedder, B.; Mellins, C.; Silverman, N.; Jeremy, Rita; McEvoy, R.; Hutton, N.; Griffith, B.; Joyner, M.; Kiefner, C.; Acker, M.; Croteau, R.; McLellan, C.; Mohan, K.; Breiger, David; Bamji, M.; Pathak, I.; Manwani, S.; Patel, E.; Abreu, Evelyn; Glass, P.; New, M.; Marshall, D.; Lyon, M.; Lee, S.; Bowden, Margaret; Ackerson, J.; Marullo, D.; Teppler, V.; Bonagura, V. R.; Schuval, S. J.; Colter, C.; Campbell, L.; Gyato, Kunsang; Chase, Cynthia; Smith, Renee; Schneider, J.; Milazzo, M.; Puga, A.; Kalish, Barbara; O'Donnell, Karen; Wiley, Felicia; Whitfield, Kareema; Donnelly, Maragaret; Champion, S.; Frere, M.; DiGrado, M.; Abrams, E. J.; Martinez, J.; Mancao, M.; Isenberg, Gary; McKeeman, J.; Figueroa, W.; Reyes, E.; Weiner, L. B.; Contello, K. A.; Holz, W. A.; Famiglietti, M. J.; Schiavoni, L.; Fernandez, A. D.; Hughes, P. A.; Wade, N.; Adams, M. E.; Shaw, R.; Piatt, J. P.; Foti, J.; Clarke-Steffen, L.; Sleasman, J.; Delaney, C.; Cohen, M.; Kiernan, B.; Andiman, W. A.; Romano, S.; Hurst, L.; De Jesus, J.; Westerveld, Michael; Wilson, G.; Lee, Evon B.; Adams, Heather; Weinberg, Geoffrey A.; Murante, Barbra; Laverty, Susan; Hutchcon, N.; Townley, A.; Nesheim, S.; Dennis, R.; Lindsey-Blue, D.; Chenneville, T.; Vandewater, V.; Johnson, G. M.; Gay, H.; Sadler, S.; Mastandrea, T.; Hickel-Rathburn, Karen; Johnson, D.; Church, J.; Dunaway, T.; Salata, C.; Deveikis, A.; Melton, L.; Gaur, S.; Whitley-Williams, P.; Malhotra, A.; Cerracchio, L.; Dolan, M.; D'Agostino, J.; Posada, R.; Mani, C.; Cobb, S.; Lavoie, S. R.; Smith, T. Y.; Feingold, A.; Burrows-Clark, S.; Mrus, J.; Beiting, R.; Cass, J.; Murdock, K.; Yates, Keith; Albritton, W.; Warford, R.; Arpadi, S.; Gershon, A.; Miller, P.; Rubinstein, A.; Krienik, G.; Nguyen, M.; Chau, M.; Waxman, T.; Forbes, C.; Wara, D.; Kamrin, A.; Farrales, S.; Johan-Liang, R.; O'Keefe, K.; Sirl, K.; Cradock, M.; Pahwa, S.; Rodriquez, L.; Cagle, S.; Pettit-Kekel, K.; Silio, M.
In: Journal of Pediatric Psychology, Vol. 34, No. 2, 03.2009, p. 164-175.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - The role of cognitive functioning in medication adherence of children and adolescents with HIV infection
AU - Malee, Kathleen
AU - Williams, Paige L.
AU - Montepiedra, Grace
AU - Nichols, Sharon
AU - Sirois, Patricia A.
AU - Storm, Deborah
AU - Farley, John
AU - Kammerer, Betsy
AU - Turcich, M.
AU - Harris, L.
AU - Iovino, I.
AU - Usitalo, Ann
AU - Rathore, Mobeen H.
AU - Mirza, Ayesha
AU - Mahmoudi, Saniyyah
AU - Malee, K.
AU - Cruz, C.
AU - Scalley, Nydia
AU - Khadivi, A.
AU - Miranda, D.
AU - Scott, G. B.
AU - Mitchell, C. D.
AU - Taybo, L.
AU - Willumsen, S.
AU - Adubato, Susan
AU - Hanna, Jennis
AU - Sirois, P.
AU - Nichols, S.
AU - Wilson, S.
AU - Shaw, R.
AU - Grant, Mitzie L.
AU - Chen, Janet S.
AU - Foster, Jill A.
AU - McQuiston, Susan
AU - Homans, J.
AU - Neely, M.
AU - Spencer, L. S.
AU - Kovacs, A.
AU - Kammerer, B.
AU - Meade, J.
AU - Rothermel, R.
AU - Schuster, L.
AU - Yumoto, C.
AU - Miles, M.
AU - Cooper, T.
AU - Garvie, Patricia
AU - Borkowsky, W.
AU - Chandwani, S.
AU - Deygoo, N.
AU - Akleh, S.
AU - Bewley, S.
AU - Rohwedder, B.
AU - Mellins, C.
AU - Silverman, N.
AU - Jeremy, Rita
AU - McEvoy, R.
AU - Hutton, N.
AU - Griffith, B.
AU - Joyner, M.
AU - Kiefner, C.
AU - Acker, M.
AU - Croteau, R.
AU - McLellan, C.
AU - Mohan, K.
AU - Breiger, David
AU - Bamji, M.
AU - Pathak, I.
AU - Manwani, S.
AU - Patel, E.
AU - Abreu, Evelyn
AU - Glass, P.
AU - New, M.
AU - Marshall, D.
AU - Lyon, M.
AU - Lee, S.
AU - Bowden, Margaret
AU - Ackerson, J.
AU - Marullo, D.
AU - Teppler, V.
AU - Bonagura, V. R.
AU - Schuval, S. J.
AU - Colter, C.
AU - Campbell, L.
AU - Gyato, Kunsang
AU - Chase, Cynthia
AU - Smith, Renee
AU - Schneider, J.
AU - Milazzo, M.
AU - Puga, A.
AU - Kalish, Barbara
AU - O'Donnell, Karen
AU - Wiley, Felicia
AU - Whitfield, Kareema
AU - Donnelly, Maragaret
AU - Champion, S.
AU - Frere, M.
AU - DiGrado, M.
AU - Abrams, E. J.
AU - Martinez, J.
AU - Mancao, M.
AU - Isenberg, Gary
AU - McKeeman, J.
AU - Figueroa, W.
AU - Reyes, E.
AU - Weiner, L. B.
AU - Contello, K. A.
AU - Holz, W. A.
AU - Famiglietti, M. J.
AU - Schiavoni, L.
AU - Fernandez, A. D.
AU - Hughes, P. A.
AU - Wade, N.
AU - Adams, M. E.
AU - Shaw, R.
AU - Piatt, J. P.
AU - Foti, J.
AU - Clarke-Steffen, L.
AU - Sleasman, J.
AU - Delaney, C.
AU - Cohen, M.
AU - Kiernan, B.
AU - Andiman, W. A.
AU - Romano, S.
AU - Hurst, L.
AU - De Jesus, J.
AU - Westerveld, Michael
AU - Wilson, G.
AU - Lee, Evon B.
AU - Adams, Heather
AU - Weinberg, Geoffrey A.
AU - Murante, Barbra
AU - Laverty, Susan
AU - Hutchcon, N.
AU - Townley, A.
AU - Nesheim, S.
AU - Dennis, R.
AU - Lindsey-Blue, D.
AU - Chenneville, T.
AU - Vandewater, V.
AU - Johnson, G. M.
AU - Gay, H.
AU - Sadler, S.
AU - Mastandrea, T.
AU - Hickel-Rathburn, Karen
AU - Johnson, D.
AU - Church, J.
AU - Dunaway, T.
AU - Salata, C.
AU - Deveikis, A.
AU - Melton, L.
AU - Gaur, S.
AU - Whitley-Williams, P.
AU - Malhotra, A.
AU - Cerracchio, L.
AU - Dolan, M.
AU - D'Agostino, J.
AU - Posada, R.
AU - Mani, C.
AU - Cobb, S.
AU - Lavoie, S. R.
AU - Smith, T. Y.
AU - Feingold, A.
AU - Burrows-Clark, S.
AU - Mrus, J.
AU - Beiting, R.
AU - Cass, J.
AU - Murdock, K.
AU - Yates, Keith
AU - Albritton, W.
AU - Warford, R.
AU - Arpadi, S.
AU - Gershon, A.
AU - Miller, P.
AU - Rubinstein, A.
AU - Krienik, G.
AU - Nguyen, M.
AU - Chau, M.
AU - Waxman, T.
AU - Forbes, C.
AU - Wara, D.
AU - Kamrin, A.
AU - Farrales, S.
AU - Johan-Liang, R.
AU - O'Keefe, K.
AU - Sirl, K.
AU - Cradock, M.
AU - Pahwa, S.
AU - Rodriquez, L.
AU - Cagle, S.
AU - Pettit-Kekel, K.
AU - Silio, M.
N1 - Funding Information: We thank the children and their families, the Study Team and the individuals and institutions involved in the conduct of PACTG 219C for contributing to this research. This study was funded by the United States National Institute of Allergy and Infectious Diseases. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials group at the Harvard School of Public Health under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5U01 A141110. The following institutions were involved in the design, data collection, and conduct of PACTG 219C, but were not involved in the present analysis, the interpretation of the data, the writing of the article, or the decision to submit for publication.
PY - 2009/3
Y1 - 2009/3
N2 - Objective: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection. Methods: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors. Results: Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence. Conclusion: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.
AB - Objective: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection. Methods: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors. Results: Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence. Conclusion: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.
KW - Adolescents
KW - Children
KW - Cognitive functioning
KW - HIV
KW - Medication adherence
UR - http://www.scopus.com/inward/record.url?scp=60749113748&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=60749113748&partnerID=8YFLogxK
U2 - 10.1093/jpepsy/jsn068
DO - 10.1093/jpepsy/jsn068
M3 - Article
C2 - 18647794
AN - SCOPUS:60749113748
VL - 34
SP - 164
EP - 175
JO - Journal of Pediatric Psychology
JF - Journal of Pediatric Psychology
SN - 0146-8693
IS - 2
ER -