- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00218634
Skills Based Counseling for Adherence and Depression in HIV+ Methadone Patients - 1
CBT for Depression & Adherence in HIV Methadone Patients
Patients with HIV, depression, and opioid-dependence are at high risk for poor health outcomes. This is a two-arm randomized controlled trial of cognitive-behavioral therapy for depression and HIV medication adherence in patients with opioid dependence who are receiving methadone maintenance treatment. The project is based on our pilot work with close attention to NIDA guidelines for a staged approach to treatment development and testing (Rounsaville et al., 2001).
Depression is highly comorbid with both HIV infection and with opioid dependence. Depression and substance abuse are both associated with poor adherence to antiretroviral medications. Patients with HIV, depression, and opioid dependence are at high risk for poor health outcomes. Cognitive-behavioral therapy is the most widely studied and efficacious psychosocial intervention for depression; and research by the PI and others has shown that cognitive-behavioral interventions have been successful in promoting adherence to HIV medications.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
Symptoms of depression (i.e. low motivation, poor concentration, loss of interest, sad mood, suicidal ideation) that occur in the context of substance abuse or dependence can interfere with self-care behaviors necessary for maintaining HIV care, as well as interfere with potential benefit from an intervention that focuses on adherence alone. We hypothesize that teaching skills to cope with depression will improve the outcome from an adherence intervention to promote healthier living with HIV, in HIV+ opioid dependent individuals in methadone maintenance treatment.
Overview of Research Plan. Patients who are HIV positive and who are receiving methadone maintenance for opioid dependence will be randomized to treatment with either: (1) CBT, a combination of CBT for depression and HIV medication adherence, including a single session intervention for HIV medication adherence (Life-Steps, Safren et al., 2001) in conjunction with physician feedback regarding baseline study assessments or (2) the single session intervention for HIV medication adherence (Life-Steps, Safren et al., 2001) in conjunction with physician feedback regarding baseline study assessments. Participants will be followed for one-year post-randomization.
Typ studie
Zápis (Aktuální)
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
-
-
Massachusetts
-
Boston, Massachusetts, Spojené státy, 02114
- Massachusetts General Hospital
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- HIV seropositive
- Currently enrolled in methadone maintenance treatment for at least one month
- Current major or subsyndromal depression (subsyndromal depression is defined by major depression that does not meet full diagnostic criteria but with a clinical global impression of severity (CGI-S) of 2 (mildly ill))
- Is prescribed antiretroviral therapy for HIV and therefore under the care of a primary care provider.
- Between the ages of 18 and 65.
Exclusion Criteria:
- Active untreated, unstable, major mental illness (i.e., untreated psychosis or mania), or other Axis I psychiatric disorders (other than depression) that would interfere with the ability to participate (i.e. CGI-S >6)
- Unable or unwilling to provide informed consent.
- Currently in cognitive behavioral therapy for depression.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
---|---|
Experimentální: CBT-AD
Cognitive behavioral therapy for adherence and depression
|
Cognitive behavioral therapy for adherence and depression consisting of 1 session focusing on adherence and 8 sessions consisting of cognitive behavioral therapy for medication adherence and depression.
|
Aktivní komparátor: ETAU
Enhanced treatment as usual
|
Enhanced treatment as usual consisting of 1 session focused on adherence (the same session as the CBT-AD intervention) and 8 sessions for participants to complete self-reports and collect adherence data.
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Percent Medication Adherence at 3-month Follow-up Assessment
Časové okno: 3-month assessment
|
Post-treatment assessment in adherence to HIV medication.
Doses taken were assessed by downloading information from the electronic pill cap and corroborated by participant self-report.
Adherence was calculated as the number of doses taken over the time period divided by the number of doses prescribed.
|
3-month assessment
|
Percent Medication Adherence at 12-month Follow-up Assessment
Časové okno: 12-month follow-up assessment
|
Follow-up assessment in adherence to HIV medication.
Doses taken were assessed by downloading information from the electronic pill cap and corroborated by participant self-report.
Adherence was calculated as the number of doses taken over the time period divided by the number of doses prescribed.
|
12-month follow-up assessment
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Clinician-assessed Depression Rating at 3 Month Follow-up Assessment
Časové okno: 3 month follow-up
|
Depression was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) by a clinical interviewer blind to participants' study condition.
The scale ranges from 0 to 60 with 7-19 indicating mild depression and 20-34 indicating moderate depression.
|
3 month follow-up
|
HIV Viral Load at 12-month Follow-up Assessment
Časové okno: 12-month follow-up assessment
|
HIV plasma RNA (log HIV viral load)at the 12-month follow-up assessment.
|
12-month follow-up assessment
|
CD4+ Lymphocyte Count at 12-month Follow-up Assessment.
Časové okno: 12-month follow-up assessment
|
CD4+ lymphocyte cell count at 12-month follow-up assessment.
|
12-month follow-up assessment
|
Clinician-assessed Depression at 12-month Follow-up Assessment
Časové okno: 12-month follow-up assessment
|
Depression was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) by a clinical interviewer blind to participants' study condition.
The scale ranges from 0 to 60 with 7-19 indicating mild depression and 20-34 indicating moderate depression.
|
12-month follow-up assessment
|
HIV Viral Load at 3-month Follow-up Assessment
Časové okno: 3-month assessment
|
HIV plasma RNA (log HIV viral load)at the 3-month follow-up assessment.
|
3-month assessment
|
CD4+ Lymphocyte Count at 3-month Follow-up Assessment.
Časové okno: 3-month assessment
|
CD4+ lymphocyte cell count at 3-month follow-up assessment.
|
3-month assessment
|
Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Steven Safren, Ph.D., Massachusetts General Hospital
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
- NIDA-18603-1
- R01DA018603 (Grant/smlouva NIH USA)
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
Klinické studie na CBT-AD
-
University of WashingtonNational Institute of Mental Health (NIMH); University of TexasDokončeno
-
Massachusetts General HospitalNational Institute of Mental Health (NIMH)DokončenoDeprese | HIV infekce | HIVSpojené státy
-
Baylor College of MedicineNational Institute of Mental Health (NIMH)DokončenoÚzkostné poruchy | DemenceSpojené státy
-
Massachusetts General HospitalDokončenoDeprese | Diabetes typu 1Spojené státy
-
Massachusetts General HospitalNational Institute of Mental Health (NIMH)Dokončeno
-
Addpharma Inc.Dokončeno
-
Addpharma Inc.Dokončeno
-
Addpharma Inc.Zatím nenabírámeHypertenze, esenciální
-
Addpharma Inc.Nábor
-
Addpharma Inc.Dokončeno