Multisystemic therapy for poorly adherent youth with HIV: results from a pilot randomized controlled trial.
Multisystemic therapy for poorly adherent youth with HIV: results from a pilot randomized controlled trial.
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DOI：
10.1080/09540121.2012.715134
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发表时间：
2013
期刊：
影响因子：
1.7
通讯作者：
Fowler S
中科院分区：
文献类型：
--
作者：
Letourneau EJ;Ellis DA;Naar-King S;Chapman JE;Cunningham PB;Fowler S
Adherence to antiretroviral medication for the treatment of HIV is a significant predictor of virologic suppression and is associated with dramatic reductions in mortality and morbidity and other improved clinical outcomes for pediatric patient populations. Effective strategies for addressing adherence problems in youth infected with HIV are needed and require significant attention to the complex interplay of multiple, interacting causal risk factors that lead to poor self-care. Within the context of a pilot randomized trial, we evaluated the feasibility and initial efficacy of a multisystemic therapy (MST) intervention adapted to address HIV medication adherence problems against a usual care condition that was bolstered with a single session of motivational interviewing (MI). For 34 participating youth, health outcomes (viral load and CD4 count) were obtained from approximately 10 months pre-baseline through approximately 6 months post-baseline and self-reported medication adherence outcomes were obtained quarterly from baseline through 9 months post-baseline. Using mixed-effects regression models we examined within and between-groups differences in the slopes of these outcomes. Feasibility was supported, with a 77% recruitment rate and near-maximal treatment and research retention and completion rates. Initial efficacy also was supported, with the MST condition but not the MI condition demonstrating statistically and clinically significant viral load reductions following the start of treatment. There also was some support for improved CD4 count and self-reported medication adherence for the MST but not the MI condition. MST was successfully adapted to improve the health outcomes of youth poorly adherent to antiretroviral medications. Replication trials and studies designed to identify mechanisms of action are important next steps.
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影响因子：
3.9
作者：
Moyers, TB;Martin, T;Miller, WR
通讯作者：
Miller, WR
影响因子：
4.9
作者：
Ellis, DA;Naar-King, S;Secord, E
通讯作者：
Secord, E
DOI：
10.1080/09540120412331299753
发表时间：
2005-04-01
影响因子：
1.7
作者：
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通讯作者：
Arfken, C
DOI：
10.1177/104438949507601004
发表时间：
1995-12-01
期刊：
FAMILIES IN SOCIETY-THE JOURNAL OF CONTEMPORARY HUMAN SERVICES
影响因子：
--
作者：
STUNTZNERGIBSON, D;KOREN, PE;DECHILLO, N
通讯作者：
DECHILLO, N
影响因子：
6.4
作者：
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通讯作者：
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