Feasibility and Acceptability of a Task-Shifted Intervention to Enhance Adherence to HIV Medication and Improve Depression in People Living with HIV in Zimbabwe, a Low Income Country in Sub-Saharan Africa.
Feasibility and Acceptability of a Task-Shifted Intervention to Enhance Adherence to HIV Medication and Improve Depression in People Living with HIV in Zimbabwe, a Low Income Country in Sub-Saharan Africa.
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DOI：
10.1007/s10461-016-1659-4
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发表时间：
2018-01
影响因子：
4.4
通讯作者：
O'Cleirigh C
中科院分区：
文献类型：
--
作者：
Abas M;Nyamayaro P;Bere T;Saruchera E;Mothobi N;Simms V;Mangezi W;Macpherson K;Croome N;Magidson J;Makadzange A;Safren S;Chibanda D;O'Cleirigh C
我们在津巴布韦的一家艾滋病护理诊所进行了一项试点试验设计，将32名抗逆转录病毒治疗依从性差且至少有轻度抑郁症的成年人随机分配到由依从性顾问提供的六次问题解决治疗依从性和抑郁症（PST-AD）或增强型精神病护理（对照）。PST-AD的可接受性很高，如会议出席的频率和通过离职面谈的定性分析所示。PST-AD的前两个疗程的保真度>80%，但对PST-AD的依从性组分的保真度在疗程4时下降。发生了污染，因为对照组中的7名患者在随访评估之前接受了一次或两次PST-AD治疗。常规健康记录被证明不可靠的测量艾滋病毒载量在后续行动。以电子方式测量依从性的障碍包括设备故障和参与者对研究设备帮助的感知。该研究无法检测临床差异，然而，6个月随访时，在电子依从性、病毒载量抑制（PST-AD组9/12例受抑制;对照组4/8例受抑制）和抑郁症（患者健康问卷-PST-AD组与对照组相比，4.7分，调整后p值= 0.01）方面观察到了令人鼓舞的变化。结果为未来的任务转移PST-AD随机对照试验提供了信息和依据。
Using a pilot trial design in an HIV care clinic in Zimbabwe, we randomised 32 adults with poor adherence to antiretroviral therapy and at least mild depression to either six sessions of Problem-Solving Therapy for adherence and depression (PST-AD) delivered by an adherence counsellor, or to Enhanced Usual Care (Control). Acceptability of PST-AD was high, as indicated by frequency of session attendance and through qualitative analyses of exit interviews. Fidelity was >80% for the first two sessions of PST-AD but fidelity to the adherence component of PST-AD dropped by session 4. Contamination occurred, in that seven patients in the control arm received one or two PST-AD sessions before follow-up assessment. Routine health records proved unreliable for measuring HIV viral load at follow-up. Barriers to measuring adherence electronically included device failure and participant perception of being helped by the research device. The study was not powered to detect clinical differences, however, promising change at 6-months follow-up was seen in electronic adherence, viral load suppression (PST-AD arm 9/12 suppressed; control arm 4/8 suppressed) and depression (Patient Health Questionnaire—4.7 points in PST-AD arm vs. control, adjusted p value = 0.01). Results inform and justify a future randomised controlled trial of task-shifted PST-AD.
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影响因子：
--
作者：
Gupta SK
通讯作者：
Gupta SK
影响因子：
2.9
作者：
Kobin, Allison Beth;Sheth, Neha Umesh
通讯作者：
Sheth, Neha Umesh
DOI：
10.1097/qai.0000000000000258
发表时间：
2014-09-01
影响因子：
3.6
作者：
Chibanda, Dixon;Benjamin, Laura;Abas, Melanie
通讯作者：
Abas, Melanie
影响因子：
168.9
作者：
Lester, Richard T.;Ritvo, Paul;Plummer, Francis A.
通讯作者：
Plummer, Francis A.
影响因子：
12.8
作者：
Bell, Alissa C.;D'Zurilla, Thomas J.
通讯作者：
D'Zurilla, Thomas J.