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N2 - Adherence is a major factor in the effectiveness of preexposure prophylaxis (PrEP) for HIV prevention. © 2016, The American College of Clinical Pharmacology The Partners PrEP Study was funded through a research grant from the Bill & Melinda Gates Foundation (grant ID #OOP47674) and current analysis was supported by a subaward from MGH to Mercer University. The authors would like to thank the study participants, DF/Net Inc for data coordination, Stephen Becker from the Bill and Melinda Gates Foundation, and the study teams: Tororo (Aloysious Kakia, Michael Enyakoit, and other team members) Kampala (Edith Nakku-Joloba, Kenneth Mugwanya, and other team members) and Kabwohe (Stephen Asiimwe, Alex Kintu, Deo Agaba, Rogers Twesgiye, and other team members). T1 - Markov Mixed Effects Modeling Using Electronic Adherence Monitoring Records Identifies Influential Covariates to HIV Preexposure Prophylaxis Our findings suggest adherence interventions should consider the role of these factors.",
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Female sex and older age had a positive impact on adherence, whereas Sundays, sexual abstinence, and sex with a partner other than the study partner had a negative impact on adherence. A third-order Markov model gave the lowest OFV and AIC, but the simpler first-order model was used for covariate model building because no additional benefit on prediction of target measures was observed for higher-order models. Markov models better described the data than 1-coin models. Covariates were included based on forward addition (α = 0.05) and backward elimination (α = 0.001). Model selection criteria included objective function value (OFV), Akaike information criterion (AIC), visual predictive checks, and posterior predictive checks. One-coin and first- to third-order Markov models were fit to the data using NONMEM 7.2. This study included once-daily dosing regimens of placebo, oral tenofovir disoproxil fumarate (TDF), and TDF in combination with emtricitabine (FTC), administered to HIV-uninfected members of serodiscordant couples. Electronic adherence records (date and time of medication bottle cap opening) from the Partners PrEP ancillary adherence study with a total of 1147 subjects were used. We developed a Markov mixed-effects model to understand the covariates influencing adherence patterns to daily oral PrEP.
Nonmem markov model trial#
Modeling patterns of adherence helps to identify influential covariates of different types of adherence as well as to enable clinical trial simulation so that appropriate interventions can be developed. Our findings suggest adherence interventions should consider the role of these factors.Ībstract = "Adherence is a major factor in the effectiveness of preexposure prophylaxis (PrEP) for HIV prevention. One-coin and first- to third-order Markov models were fit to the data using NONMEM ® 7.2.
![nonmem markov model nonmem markov model](https://cyberleninka.org/viewer_images/837696/f/1.png)
Adherence is a major factor in the effectiveness of preexposure prophylaxis (PrEP) for HIV prevention.