- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT02329782
Supporting Treatment Adherence Readiness Through Training (START) (START)
Controlled Evaluation of the Adherence Readiness Program for ART Adherence
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Einschreibung (Voraussichtlich)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
-
-
California
-
Long Beach, California, Vereinigte Staaten
- Care Clinic
-
Los Angeles, California, Vereinigte Staaten
- T.H.E. Clinic
-
Los Angeles, California, Vereinigte Staaten
- UCLA CARE Center
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
The patient's provider views the patient as medically appropriate to begin (ART naïve) or restart ART (has been off ART for at least 2 months), and either
- plans to start the patient on ART
- would like to start the patient on ART but the provider or patient is uncertain about the patient's readiness to adhere well.
Patients who are currently on ART are also eligible if they meet the following criteria, which are specific only to this type of patient:
i) the patient has 2 or more HIV viral load tests in the past year > 1000 copies/ml ii) the patient has had no HIV viral load tests that were undetectable in the past year iii) the patient has a genotype in the past year that does not show resistance as a reason for virologic failure (detectable viral load) iv) primary care provider views the patient as a good candidate for the study, with the understanding that the patient will interrupt ART if assigned to the intervention.
Criteria i to iii are intended to define a subgroup of nonadherent patients who are taking very little of their ART medications, as evidenced by the combination of consistently high viral load and no drug resistance. If the patient was taking at least a moderate level of drug and still had consistently high viral load, than they would have evidence of drug resistance. Providers are generally comfortable with this type of patient stopping their medication in order to facilitate the pre-treatment, adherence readiness assessment and training phase of the intervention prior to restarting the patient on treatment.
- The patient's health status is stable. There is no current acute OI or medical condition that calls for immediate ART, as determined by the patient's provider.
- Most recent HIV viral load is detectable.
- If CD4 < 200, the patient is on or will be prescribed prophylactic medication
- Patient is 18 or older.
- Patient is able and willing to give informed consent.
- English speaking.
Exclusion Criteria:
1. Patient just tested HIV+ and their provider suspects the patient may be acutely or recently infected (within past 6 months).
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 |
---|---|
Experimental: ARP intervention
Adherence counseling intervention
|
The ARP consists of pre-treatment (including practice trials to determine readiness for and timing of ART initiation), early-treatment, and ongoing maintenance training (using a performance-based, dose regulation mechanism to tailor the amount and intensity) phases
|
Kein Eingriff: usual care
no intervention, standard care practices regarding adherence support
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
HIV virologic suppression
Zeitfenster: Month 24
|
undetectable HIV viral load at time of assessment
|
Month 24
|
log change in HIV viral load (log change in HIV RNA levels)
Zeitfenster: Month 24
|
log change in HIV RNA levels from baseline to Month 24.
|
Month 24
|
optimal dose-taking adherence (whether at least 85% of prescribed doses were taken)
Zeitfenster: Month 24
|
binary variable representing whether at least 85% of prescribed doses were taken between baseline and Month 24
|
Month 24
|
percent dose-taking adherence
Zeitfenster: Month 24
|
percent of prescribed doses taken between baseline and Month 24
|
Month 24
|
HIV virologic suppression
Zeitfenster: Month 6
|
undetectable HIV viral load at time of assessment
|
Month 6
|
log change in HIV viral load (log change in HIV RNA levels)
Zeitfenster: Month 6
|
log change in HIV RNA levels from baseline to Month 6
|
Month 6
|
optimal dose-taking adherence (whether at least 85% of prescribed doses were taken)
Zeitfenster: month 6
|
binary variable representing whether at least 85% of prescribed doses were taken between baseline and Month 6
|
month 6
|
percent dose-taking adherence
Zeitfenster: month 6
|
percent of prescribed doses taken between baseline and Month 6
|
month 6
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
dose-timing adherence
Zeitfenster: Month 24
|
percent of prescribed doses taken within correct time-window between baseline and Month 24
|
Month 24
|
dose-timing adherence
Zeitfenster: Month 6
|
percent of prescribed doses taken within correct time-window between baseline and Month 6
|
Month 6
|
optimal dose-timing adherence
Zeitfenster: Month 24
|
binary variable representing whether at least 85% of prescribed doses were taken within correct time-window between baseline and Month 24
|
Month 24
|
optimal dose-timing adherence
Zeitfenster: Month 6
|
binary variable representing whether at least 85% of prescribed doses were taken within correct time-window between baseline and Month 6
|
Month 6
|
change in CD4 count
Zeitfenster: Month 24
|
change in CD4 count from baseline to Month 24
|
Month 24
|
change in CD4 count
Zeitfenster: Month 6
|
change in CD4 count from baseline to Month 6
|
Month 6
|
clinic attendance (number of missed clinic appointments)
Zeitfenster: Month 24
|
number of missed clinic appointments between baseline and Month 24
|
Month 24
|
clinic attendance (number of missed clinic appointments)
Zeitfenster: Month 6
|
number of missed clinic appointments between baseline and Month 6
|
Month 6
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Glenn Wagner, PhD, RAND
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Wagner GJ, Seelam R, Hoffman R, Ghosh-Dastidar B. Mediators and moderators of ART adherence effects of supporting treatment adherence readiness through training (START): evidence that START helps vulnerable clients achieve better adherence. AIDS Care. 2022 Oct;34(10):1249-1256. doi: 10.1080/09540121.2021.2006133. Epub 2021 Nov 21.
- Wagner GJ, Hoffman R, Linnemayr S, Schneider S, Ramirez D, Gordon K, Seelam R, Ghosh-Dastidar B. START (Supporting Treatment Adherence Readiness through Training) Improves Both HIV Antiretroviral Adherence and Viral Reduction, and is Cost Effective: Results of a Multi-site Randomized Controlled Trial. AIDS Behav. 2021 Oct;25(10):3159-3171. doi: 10.1007/s10461-021-03188-x. Epub 2021 Apr 2.
- Wagner GJ, Linnemayr S, Ghosh-Dastidar B, Currier JS, Hoffman R, Schneider S. Supporting Treatment Adherence Readiness through Training (START) for patients with HIV on antiretroviral therapy: study protocol for a randomized controlled trial. Trials. 2016 Mar 24;17:162. doi: 10.1186/s13063-016-1287-3.
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
Andere Studien-ID-Nummern
- MH104086
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
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