- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT02206906
Incentives to Promote Medication Adherence Among HIV-Infected Youth
Investigation of Incentives to Promote Medication Adherence Among HIV-Infected Youth on Antiretroviral Therapy
Tutkimuksen yleiskatsaus
Yksityiskohtainen kuvaus
PRIMARY OBJECTIVE:
- To describe the effects of a novel incentive intervention model on HIV-infected youths' patterns of antiretroviral medication adherence.
SECONDARY OBJECTIVES:
- To evaluate the feasibility of an outpatient incentive intervention model.
- To assess participant satisfaction with the incentive intervention model.
- To evaluate the effect of an outpatient incentive intervention model on targeted health behaviors (numbers of missed appointments and STI diagnoses).
- To measure the effect of the incentive intervention on HIV viral load and CD4+ count.
- To determine the overall and per patient cost of the incentive intervention model.
- To describe associations between adherence measures: real-time medication monitor data, pharmacy pill count, pharmacy prescription pick-up data, medication possession ratio, and self-report.
Upon enrollment, participants will receive education and a real-time medication monitor. Participants will be followed monthly in the clinic and will be prescribed thirty-day supplies of medication. During weeks 1-4 participants will establish a baseline with the real-time medication monitor. During weeks 5-28, participants will receive remote incentives based on their level of medication adherence as measured by the real-time medication monitor. Additional lottery-style incentives will occur at regular follow-up visits. No incentives will be applied during weeks 29-48. Participants will complete the protocol at the week 48 visit.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Yhteystiedot ja paikat
Opiskelupaikat
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Tennessee
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Memphis, Tennessee, Yhdysvallat, 38105
- St. Jude Children's Research Hospital
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- ≥16 and ≤ 24 years old
- Documented diagnosis of HIV
- Adolescent is aware of his/her HIV diagnosis
- Adolescent understands either written or spoken English.
- Adolescent is willing and able to provide informed consent or assent.
- Adolescent has access to a phone and the internet at the time of enrollment.
Adolescent meets the definition of inadequate ARV adherence, which is any of the following in the previous 12 months:
- < 80% adherent to any ARV by pharmacy pill count
- ≥ 7 days delay in scheduled ARV prescription pick-up
- Detectable viral load after being on ARVs for at least 12 weeks
Exclusion Criteria:
- Adolescent has a documented diagnosis of mental retardation or a significant motor or sensory impairment that would preclude participation.
- Adolescent has a documented acute psychiatric illness, including suicidal ideation, homicidal ideation or active psychosis.
- Adolescent was diagnosed with HIV in the previous 6 months.
- Adolescent has a planned transition to alternative care setting prior to study completion (e.g. relocation, pregnancy or planned pregnancy, transition to adult care).
- Concurrent enrollment on a research study with an intervention targeted at increasing adherence to antiretroviral regimens.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Havaintomallit: Kohortti
- Aikanäkymät: Tulevaisuuden
Kohortit ja interventiot
Ryhmä/Kohortti |
Interventio / Hoito |
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Study Participants
All participants who meet eligibility requirements and who consent to participation will use an incentive intervention model.
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All participants will receive a real-time electronic medication monitor to monitor daily pill-taking behavior.
Participants with qualifying levels of adherence will receive a weekly incentive during the intervention period.
At all clinic visits participants will participate in a lottery incentive to reinforce clinic attendance and negative STI screening tests.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Percentage of dosages taken within 2 hours of prescribed time per month
Aikaikkuna: Monthly through week 48
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Data collected by a real-time medication monitor that records pillbox opening times.
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Monthly through week 48
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Pharmacy pill count
Aikaikkuna: Monthly from 6 months prior to study start through week 48
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Pharmacy pill count data is collected at each participant encounter, approximately once per month.
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Monthly from 6 months prior to study start through week 48
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Feasibility - Accrual percentage
Aikaikkuna: End of study (week 48)
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Number of people enrolled in study/number approached for enrollment.
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End of study (week 48)
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Feasibility - Drop out rate
Aikaikkuna: End of study (week 48)
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Number of people ending protocol early/ total enrollment
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End of study (week 48)
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Feasibility - Participant reported device concerns
Aikaikkuna: End of study (week 48)
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Problems with the Wisepill devices as spontaneously reported by participants or as assessed at routine follow-up.
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End of study (week 48)
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Feasibility - Device replacement rate
Aikaikkuna: End of study (week 48)
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Number of devices requiring replacement due to loss/theft/breakage
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End of study (week 48)
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Feasibility - Contact failure rate
Aikaikkuna: End of study (week 48)
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Number of failed attempts to contact participants/total number of contact attempts made
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End of study (week 48)
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Feasibility - Staff hours per week
Aikaikkuna: End of study (week 48)
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Hours spent providing remote incentives
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End of study (week 48)
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Feasibility - Adverse effects of incentives
Aikaikkuna: End of study (week 48)
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Unexpected risks/harms of providing incentives as self-reported by participants.
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End of study (week 48)
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Percentage of participants who are satisfied with the incentive intervention
Aikaikkuna: Enrollment (week 0) and end of study (week 48)
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To assess participant satisfaction with the incentive intervention model.
Patient satisfaction, assessed by ACASI survey, will be summarized and tabulated for baseline (week 0) and follow-up (week 48) measurements.
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Enrollment (week 0) and end of study (week 48)
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Effect of incentives on missed appointment rate
Aikaikkuna: Enrollment (week 0) and end of study (week 48)
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Descriptive statistics of numbers of missed appointments such as mean, interquartile range and median, during each study phase will be computed and compared
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Enrollment (week 0) and end of study (week 48)
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Effect of incentives on STI rates
Aikaikkuna: Enrollment (week 0) and end of study (week 48)
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Descriptive statistics of numbers of STI rates such as mean, interquartile range and median, during each study phase will be computed and compared
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Enrollment (week 0) and end of study (week 48)
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Change in biological parameters
Aikaikkuna: At weeks 0, 12, 24, 36 and 48
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To measure the effect of the incentive intervention on HIV viral load and CD4+ count.
HIV viral load and CD4+ count measured at week 0, 12, 24, 36 and 48 will be summarized and plotted by descriptive statistics, such as mean and standard deviation.
Mixed effects models will be applied to explore the effect of the intervention on HIV viral load and CD4+ count.
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At weeks 0, 12, 24, 36 and 48
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Overall cost of incentive intervention
Aikaikkuna: End of study (week 48)
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To determine the overall and per patient cost of the incentive intervention model the accumulated overall and per patient cost till week 48 will be summarized and tabulated.
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End of study (week 48)
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Association between adherence measures
Aikaikkuna: End of study (week 48)
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To describe associations between adherence measures: Wisepill data, pharmacy pill count, pharmacy prescription pick-up data, medication possession ratio, and self-report.
Associations of Wisepill adherence rates with pill count and pick up rates will be described by Pearson or Spearman's correlation coefficients and intraclass correlation coefficients as appropriate.
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End of study (week 48)
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Yhteistyökumppanit ja tutkijat
Tutkijat
- Päätutkija: Ronald Dallas, PhD, St. Jude Children's Research Hospital
Julkaisuja ja hyödyllisiä linkkejä
Hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muut tutkimustunnusnumerot
- INMED
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