- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico 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.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Massachusetts
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Boston, Massachusetts, Estados Unidos, 02114
- Massachusetts General Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Experimental: CBT-AD
Cognitive behavioral therapy for adherence and depression
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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.
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Comparador Ativo: ETAU
Enhanced treatment as usual
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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.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Percent Medication Adherence at 3-month Follow-up Assessment
Prazo: 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
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Percent Medication Adherence at 12-month Follow-up Assessment
Prazo: 12-month follow-up assessment
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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
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Clinician-assessed Depression Rating at 3 Month Follow-up Assessment
Prazo: 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
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HIV Viral Load at 12-month Follow-up Assessment
Prazo: 12-month follow-up assessment
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HIV plasma RNA (log HIV viral load)at the 12-month follow-up assessment.
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12-month follow-up assessment
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CD4+ Lymphocyte Count at 12-month Follow-up Assessment.
Prazo: 12-month follow-up assessment
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CD4+ lymphocyte cell count at 12-month follow-up assessment.
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12-month follow-up assessment
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Clinician-assessed Depression at 12-month Follow-up Assessment
Prazo: 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
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HIV Viral Load at 3-month Follow-up Assessment
Prazo: 3-month assessment
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HIV plasma RNA (log HIV viral load)at the 3-month follow-up assessment.
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3-month assessment
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CD4+ Lymphocyte Count at 3-month Follow-up Assessment.
Prazo: 3-month assessment
|
CD4+ lymphocyte cell count at 3-month follow-up assessment.
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3-month assessment
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Steven Safren, Ph.D., Massachusetts General Hospital
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- NIDA-18603-1
- R01DA018603 (Concessão/Contrato do NIH dos EUA)
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
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