Improving Antiretroviral Medication Adherence Among HIV-infected Youth
Improving Antiretroviral Medication Adherence Among HIV-infected Youth: Phase II
HIV is increasing among adolescents and young adults in the US. Antiretroviral medications, when taken correctly (≥ 90% of prescribed doses taken), can vastly improve life expectancy. However, adherence among HIV-infected young people is suboptimal, and few interventions are available to help adolescents adhere to treatment.
The study is a randomized controlled trial (RCT) pilot trial of Positive STEPS (the adapted form of the Life-Steps behavioral intervention) to improve medication adherence among HIV-infected youth. The study will allow us to demonstrate participant acceptance, ability to recruit, feasibility of intervention delivery with study counselors and all study procedures, and initial clinically significant improvement in medication adherence via MEMS caps. This research will lay the groundwork for a federal grant application for a multi-site randomized controlled intervention trial.
Studienübersicht
Detaillierte Beschreibung
Aims:
- To conduct a randomized controlled pilot test of a behavioral adherence intervention to improve medication adherence among HIV-infected youth aged 13-24. Feasibility of all study procedures and participant acceptability will be assessed.
- To explore whether the intervention leads to improved medication adherence among youth who receive the intervention, compared to a control group of youth who do not.
40 HIV-infected adolescents will be recruited for a RCT pilot of the Positive STEPS intervention at Fenway Health and Children's Hospital Boston. Participants will be randomized into one of two arms (half and half). Randomization for all participants will occur after the beginning of the week 2 study visit. The duration of the study is 3 months
Randomization:
The investigators will conduct block randomization based on two categories of electronic adherence: 85% or above versus < 85%. All participants will have exhibited some non-adherence in order to be eligible for the study, although they may vary in the extent of non-adherence. Because insufficient information is known about the range of non-adherence in the population to determine the most valid non-adherence cut-off points, the investigators may need to reconsider adherence categories over the course of the pilot study. The investigators will regularly examine the data to determine whether finer adherence categories are needed, and the investigators will adjust the categories if such a determination is made.
Intervention arm:
- Participants will receive one on one Positive STEPS counseling sessions (~1 hour sessions per week for 5 weeks).
- Participants will receive motivational reminders to take medications sent via text message to their cell phones
- Participants will receive the Medication Event Monitoring Systems (MEMS) pill cap monitoring device to measure antiretroviral medication adherence.
Comparison condition arm:
• Participants will receive the Medication Event Monitoring Systems (MEMS) pill cap monitoring device to measure antiretroviral medication adherence.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
-
-
Massachusetts
-
Boston, Massachusetts, Vereinigte Staaten, 02114
- Massachusetts General Hospital
-
Boston, Massachusetts, Vereinigte Staaten, 02115
- Children's Hospital Boston
-
Boston, Massachusetts, Vereinigte Staaten, 02215
- The Fenway Institute, Fenway Health
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Age 13 to 24 years
- HIV-infected
- Currently taking antiretroviral therapy or prescribed medication for HIV
- Self-reported difficulties adhering to HIV medications in the past 3 months (i.e., <95% compliant)
- If 18-24: Willing and able to provide informed consent
- If 13-17: Parent/guardian willing and able to provide parental permission and participant willing and able to provide assent
- Willing to attend all study visits
Exclusion Criteria:
- If 18-24:Unwilling or unable to provide informed consent
- If 13-17: Parent/guardian unwilling or unable to provide parental permission and participant willing and able to provide assent
- Has severe mental illness requiring immediate treatment (e.g. active psychotic episode) or a mental illness that would limit your ability to participate (e.g. dementia)
- Has severe cognitive limitation that would limit your ability to comprehend the informed consent or assent (see Decisional Capacity Determination SOP)
- Unwilling to attend all study visits
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Unterstützende Pflege
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Kein Eingriff: Condition
In the comparison condition, participants will receive MEMS only.
|
|
|
Experimental: Positive STEPS
|
This intervention is given to patients in the experimental condition only.
The Positive STEPS intervention-developed by our team-is based on general principles of cognitive-behavioral therapy as well as more specific principles of motivational interviewing32,33 and problem solving therapy.
Informational, problem solving, and cognitive-behavioral STEPS are targeted over 5, in-person, intervention sessions with a PhD-level counselor.
The intervention will also include a series of short videos related to the topics that the Positive STEPS intervention covers with participants.
Participants in the experimental condition can also choose to receive text messages sent to their cell phone to remind them to take their medication.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Electronically monitored (MEMS) antiretroviral medication adherence
Zeitfenster: 3 months
|
The primary outcome will be antiretroviral medication adherence.
Adherence will be measured through the medication event monitoring device(MEMS).
|
3 months
|
Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Hauptermittler: Matthew J Mimiaga, ScD, MPH, Massachusetts General Hospital and Fenway Health
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- RNA-Virusinfektionen
- Viruserkrankungen
- Infektionen
- Durch Blut übertragene Infektionen
- Übertragbare Krankheiten
- Sexuell übertragbare Krankheiten, viral
- Sexuell übertragbare Krankheiten
- Lentivirus-Infektionen
- Retroviridae-Infektionen
- Immunologische Mangelsyndrome
- Erkrankungen des Immunsystems
- HIV-Infektionen
Andere Studien-ID-Nummern
- CFAR Adherence HIV Youth:2
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
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 .
Klinische Studien zur HIV infektion
-
Duke UniversityAbgeschlossenCentral Line-associated Bloodstream Infection (CLABSI)Vereinigte Staaten
-
Catholic University of the Sacred HeartAbgeschlossenCentral Line-associated Bloodstream Infection (CLABSI)
-
Abbott Medical DevicesThoratec CorporationAbgeschlossenDriveline Heart-assisted Device Related InfectionVereinigte Staaten
-
University of MalayaTeleflexRekrutierungCLABSI – Central Line Associated Bloodstream InfectionMalaysia
-
Princess Maxima Center for Pediatric OncologyUMC Utrecht; Dutch Cancer SocietyRekrutierungCentral Line-associated Bloodstream Infection (CLABSI)Niederlande
-
Johns Hopkins UniversityAbgeschlossenCLABSI – Central Line Associated Bloodstream InfectionVereinigte Staaten
-
National Taiwan University Hospital Hsin-Chu BranchAbgeschlossenCentral Line-associated Bloodstream Infection (CLABSI)
-
National Taiwan University HospitalAbgeschlossenCentral Line-associated Bloodstream Infection (CLABSI)Taiwan
-
Port Said UniversityRekrutierungCentral Line-associated Bloodstream Infection (CLABSI)Ägypten
-
Boston Children's HospitalSterileCare Inc.Anmeldung auf EinladungZentrale Linienkomplikation | Central Line-associated Bloodstream Infection (CLABSI)Vereinigte Staaten
Klinische Studien zur Positive STEPS
-
Glostrup University Hospital, CopenhagenRigshospitalet, DenmarkAktiv, nicht rekrutierendChronische KrankheitDänemark
-
University of MichiganAbgeschlossenChronischer SchmerzVereinigte Staaten
-
Roswell Park Cancer InstituteAbgeschlossenPlasmazellmyelomVereinigte Staaten
-
Wake Forest University Health SciencesPatient-Centered Outcomes Research Institute; National Institute of Diabetes... und andere MitarbeiterAktiv, nicht rekrutierendChronische NierenerkrankungenVereinigte Staaten
-
University of MichiganNational Institute on Aging (NIA); American Pain SocietyAbgeschlossenChronischer SchmerzVereinigte Staaten
-
Alexandria UniversityAbgeschlossen
-
Center for Psychological ConsultationAbgeschlossenZwangsstörungVereinigte Staaten
-
University of South FloridaNational Cancer Institute (NCI)Rekrutierung
-
King's College LondonUniversity of OxfordAbgeschlossenVerhaltensproblem des Kindes | Problem der psychischen GesundheitVereinigtes Königreich
-
University of AlbertaRekrutierung