Improving Treatment Adherence in HIV-Infected Individuals
Changing ART Adherence Behavior: The Lifewindows Project
Studienübersicht
Status
Intervention / Behandlung
Detaillierte Beschreibung
When antiretroviral therapy (ART) is taken correctly, it can dramatically improve the health and well-being of HIV-infected individuals. However, when the treatment regimen is not followed carefully, the therapy can be ineffective in managing one's HIV, and also can allow for the development of strains of HIV that may be resistant to treatment. Effective ART adherence interventions can help patients to avoid potentially serious individual and public health consequences of suboptimal adherence, but such interventions are often expensive and too intensive for clinics to support offering over time to their patients. This study will develop and evaluate the effectiveness of an individualized, interactive, computer-software intervention program delivered in clinical care in increasing ART adherence in HIV-infected individuals. Because the intervention is a software program, clinic resources required for implementation and sustaining availability over time are minimized.
Participants in this ~18-month study were recruited from one of 5 participating clinics that provide HIV care and randomly assigned to control (an assessment only version of the software) or intervention (assessment and tailored intervention software) arm. Participants completed their assigned task in concert with their regularly scheduled HIV medical care visits (but no more frequently than once a month). Primary outcomes were measured at each medical visit. The effect of the adherence intervention was evaluated through comparison of treatment and control arm adherence reports over time and VL.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
-
-
Connecticut
-
Farmington, Connecticut, Vereinigte Staaten, 06030-3212
- University of Connecticut Health Center
-
Hartford, Connecticut, Vereinigte Staaten, 06102
- Hartford Hospital
-
New Haven, Connecticut, Vereinigte Staaten, 06511
- Hospital of Saint Raphael
-
New Haven, Connecticut, Vereinigte Staaten, 06510
- Yale-New Haven Hospital Nathan Smith Clinic
-
Waterbury, Connecticut, Vereinigte Staaten, 06708
- Waterbury Hospital
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- HIV-infected
- English-speaking
- Currently receiving treatment at one of the participating sites
- Currently receiving antiretroviral therapy
Exclusion Criteria:
- Marked cognitive impairment
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Sonstiges: Control
Participants will receive the control condition
|
At each clinical care visit, control arm participants use the portion of the LifeWindows software program that provides a welcome from the avatar and collection of assessment items/surveys.
|
|
Experimental: Intervention
Participants will receive the LifeWindows Intervention sessions
|
At each clinical care visit, intervention arm participants use the full LifeWindows program, which includes welcome and assessment surveys and also includes the active intervention modules.
ART adherence promotion intervention activities are tailored to the participant's assessment responses.
Participants select which activities he or she wishes to use which culminates in an adherence specific goal.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
AIDS Clinical Trials Group (ACTG) 3-day Recall Measure of Doses Taken
Zeitfenster: Measured at each clinical care visit over 18 months of participation
|
This measure asks participants to report the number of doses taken on each of the past 3-days, relative to number he or she was prescribed to take, and produces a % adherence score. For this study, adherence over the past 3-days was established for each medication separately then averaged over the full regimen. For main outcomes, perfect vs imperfect adherence was evaluated. Significant findings on perfect/imperfect adherence were followed with sensitivity tests to determine if lowest threshold (eg., 90%, 80%, 70% adherence) effect was maintained. See: Chesney MA, Ickovics JR, Chambers DB, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient care committee & adherence working group of the outcomes committee of the adult AIDS clinical trials group (AACTG). AIDS Care. 2000;12(3):255-266. |
Measured at each clinical care visit over 18 months of participation
|
|
Visual Analog Scale Measure of Adherence to ART
Zeitfenster: Measured at each clinical visit over 18 months of participation
|
This measure asks participants to rate their adherence over the past 3 to 4 weeks using a line that marks from 0 to 100% of doses taken. For this study, this item was asked for each antiretroviral in one's regimen and a total score was produced by averaging all reports. For main outcomes, perfect vs imperfect adherence was evaluated. See: Walsh JC, Mandalia S, Gazzard BG. Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. AIDS.2002;16:269-77 |
Measured at each clinical visit over 18 months of participation
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Viral Load Count
Zeitfenster: Measured over 18 months
|
Viral load data extracted from medical records beginning 30 days prior to baseline.
|
Measured over 18 months
|
Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Hauptermittler: Jeffrey D. Fisher, PhD, University of Connecticut
- Hauptermittler: K. Rivet Amico*, PhD, University of Connecticut (*co-PI)
- Hauptermittler: Deborah H. Cornman*, PhD, University of Connecticut (*co-PI)
- Hauptermittler: William A. Fisher*, PhD, University of Western Ontario (*co-PI)
Publikationen und hilfreiche Links
Nützliche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Andere Studien-ID-Nummern
- R01MH066684 (US NIH Stipendium/Vertrag)
- DAHBR 9A-ASPG (National Institute of Mental Health (NIMH-DAHBR))
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .