Development and Initial Feasibility of a Hospital-Based Acceptance and Commitment Therapy Intervention to Improve Retention in Care for Out-of-Care Persons with HIV: Lessons Learned from an Open Pilot Trial.
Development and Initial Feasibility of a Hospital-Based Acceptance and Commitment Therapy Intervention to Improve Retention in Care for Out-of-Care Persons with HIV: Lessons Learned from an Open Pilot Trial.
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DOI：
10.3390/jcm11102827
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发表时间：
2022-05-17
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
在美国，大约40%的艾滋病毒感染者（PWH）没有持续参与艾滋病毒护理。寻找失医的威尔斯亲王医院是困难的，但住院治疗是常见的，并提供了一个机会，以重新参与威尔斯亲王医院的门诊治疗。本研究的目的是：（1）发展一套以接纳与承诺疗法为基础的介入方法，以改善住院及非护理的威尔斯亲王医院病人对爱滋病病毒治疗的投入;（2）探讨介入方法的初步可行性及可接受性;（3）修订研究方案（包括干预），根据利益相关者的反馈，准备一项随机对照试验（RCT），比较ACT和常规治疗。治疗师和艾滋病毒护理专家制定了一个四期的以青蒿素综合疗法为基础的干预措施，将在住院期间提供。15名HIV控制不佳的住院患者参加了开放试验，8名完成了4个疗程，2名完成了3个疗程，7名提供了定性反馈。患者普遍喜欢干预和心理健康和艾滋病毒护理的整体方法。改进包括重复关键概念，包括代表性的图形，并翻译成西班牙语。在参加≥3次ACT治疗的患者中，5/10人参加了HIV护理随访访视，5/7人在干预后2个月进行了实验室检查，病毒载量<20。接下来的步骤包括进行一项随机临床试验，探索改进的干预措施对常规治疗的影响，以保持护理和病毒载量。ClinicalTrials.gov标识符：NCT 04481373。
Roughly 40% of persons with HIV (PWH) are not consistently involved in HIV care in the US. Finding out-of-care PWH is difficult, but hospitalization is common and presents an opportunity to re-engage PWH in outpatient care. The aims of this study were to (1) develop an Acceptance and Commitment Therapy (ACT)-based intervention for hospitalized, out-of-care PWH who endorse avoidance-coping to improve HIV treatment engagement; (2) examine the intervention’s initial feasibility and acceptability; and (3) to revise the study protocol (including the intervention), based on stakeholder feedback, in preparation for a randomized controlled trial (RCT) comparing ACT to treatment as usual. Therapists and HIV care experts developed a four-session ACT-based intervention to be delivered during hospitalization. Fifteen hospitalized patients with poorly controlled HIV enrolled in the open trial, eight completed four sessions, two completed three sessions, and seven provided qualitative feedback. Patients universally liked the intervention and the holistic approach to mental health and HIV care. Refinements included repeating key concepts, including representative graphics, and translating to Spanish. Among the patients who attended ≥3 ACT sessions, 5/10 attended a HIV-care follow-up visit and 5/7 who had labs had a viral load <20 2-months post-intervention. Next steps include conducting a randomized clinical trial exploring the impact of the refined intervention to treatment as usual on retention in care and viral load. ClinicalTrials.gov Identifier: NCT04481373.
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影响因子：
6
作者：
Earnshaw VA;Bogart LM;Laurenceau JP;Chan BT;Maughan-Brown BG;Dietrich JJ;Courtney I;Tshabalala G;Orrell C;Gray GE;Bangsberg DR;Katz IT
通讯作者：
Katz IT
影响因子：
--
作者：
Davila JA;Hartman C;Cully J;Stanley M;Amico KR;Soriano E;Minick S;May SB;Giordano TP
通讯作者：
Giordano TP
影响因子：
3.8
作者：
Katz, Ingrid T.;Bogart, Laura M.;Bangsberg, David R.
通讯作者：
Bangsberg, David R.
影响因子：
4.2
作者：
FLEISHMAN, JA;FOGEL, B
通讯作者：
FOGEL, B
DOI：
10.1097/00126334-200304010-00009
发表时间：
2003-04-01
影响因子：
3.6
作者：
Giordano, TP;White, AC;Visnegarwala, F
通讯作者：
Visnegarwala, F