{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T19:46:06Z","timestamp":1761162366715,"version":"build-2065373602"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T00:00:00Z","timestamp":1610150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AI104315","AI122298"],"award-info":[{"award-number":["AI104315","AI122298"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study Objective<\/jats:title>\n                    <jats:p>To assess the association between tenofovir diphosphate (TFV\u2010DP) in dried blood spots (DBS), a measure of cumulative tenofovir\u2010based antiretroviral (ART) adherence, with medication regimen complexity in persons with human immunodeficiency virus (PWH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective clinical cohort (up to three visits over 48 weeks).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic\u2010based HIV clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>PWH receiving tenofovir disoproxil fumarate (TDF)\u2010based ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>DBS for TFV\u2010DP were collected at every study visit. Baseline patient\u2010level medication regimen complexity index (pMRCI) scores were calculated and categorized into three sub\u2010scores (disease\u2010specific [ART], non\u2010ART, and over\u2010the\u2010counter [OTC]). The pMRCI scores were evaluated to assess the association with TFV\u2010DP in DBS &lt;350 fmol\/punch after adjusting for clinical covariates. pMRCI scores were also categorized to estimate the adjusted relative risk (aRR) of having a TFV\u2010DP &lt;350 fmol\/punch between pMRCI quartiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Data from 525 participants (1,146 person\u2010visits) were analyzed. Baseline median (interquartile range [IQR]) pMRCI scores for participants with TFV\u2010DP in DBS &lt;350 vs. \u2265350 fmol\/punch were 4 (3, 8) vs. 4 (2, 6) for ART, 27 (12, 31) vs. 12 (5, 22) for non\u2010ART, and 0 (0, 1) vs. 0 (0, 2) for OTC, respectively. For the non\u2010ART scores, the aRR for having a TFV\u2010DP in DBS &lt;350 fmol\/punch was 6.4 (95% CI: 2.0, 20.6; P=0.002) when comparing participants in the highest pMRCI quartile with those in the lowest quartile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher pMRCI for non\u2010ART medications is associated with lower adherence as measured by TFV\u2010DP in DBS. Future research should investigate whether reducing non\u2010ART medication complexity improves ART adherence and exposure in PWH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2490","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T11:54:33Z","timestamp":1607169273000},"page":"291-298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Higher medication complexity in persons with HIV is associated with lower tenofovir diphosphate in dried blood spots"],"prefix":"10.1002","volume":"41","author":[{"given":"Austin M.","family":"Saderup","sequence":"first","affiliation":[{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences University of Colorado\u2010AMC Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Morrow","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics 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