NURSE CASE MANAGERS' HOME-BASED HIV ADHERENCE TRIAL

护士病例经理的家庭艾滋病毒依从性试验

• 批准号: 6017372
• 负责人: WILLIAM L HOLZEMER
• 金额: $ 43.17万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6017372
• 关键词: AIDS therapy; antiAIDS agent; clinical research; clinical trials; drug resistance; health care service utilization; helper T lymphocyte; home health care; human immunodeficiency virus; human subject; human therapy evaluation; leukocyte count; nursing intervention; patient care management; quality of life; therapy compliance; virus load

DESCRIPTION (Adapted from Applicant's Abstract): Highly active antiretroviral therapy (HAART) that includes a protease inhibitor has led to significant reductions in HIV-related morbidity and mortality. However, the challenge of adhering to HAART therapy is immense. This revised application proposes a randomized clinical trial to test a standardized HAART adherence intervention program, Client Adherence Profiling-Intervention Tailoring (CAP-IT), implemented by nurse case managers during regularly scheduled home visits, for clients (n=222) newly admitted in the AIDS Case Management Program, Office of AIDS, State of California. CAP-IT is an innovative, structured nursing assessment and care planning activity that allows a standardized assessment of client needs and tailored HAART intervention strategies. CAP-IT is significantly different from the current standard nursing case management practice. The study aims are: 1) To test if a standardized adherence intervention program, compared to standard care, results in improved HAART adherence rates; 2) To test if a standardized adherence intervention program, compared to standard care, impacts CD4 count, viral load, and HAART resistance; 3) To test if there is a relationship between adherence and CD4 count, viral load, and HAART resistance; 4) To test if a standardized adherence intervention program, compared to standard care, impacts clients' quality of life; and, 5) To test if a standardized adherence intervention program, compared to standard care, impacts health-related resource utilization. The review of the literature supports the significance of the issue of adherence to HAART therapy and the need for further research focused on the effectiveness of interventions aimed at improving adherence and subsequent health-related outcomes. Evidence is also provided to support the feasibility of utilizing nurse case managers to delivery a home care-based adherence intervention.

描述（改编自申请人的摘要）：高效抗逆转录病毒药物 包括蛋白酶抑制剂的治疗（HAART）已导致显着的 降低艾滋病毒相关发病率和死亡率。然而，挑战 坚持HAART治疗是巨大的。该修订后的申请提出了 测试标准化 HAART 依从干预的随机临床试验 计划，客户依从性分析-干预定制（CAP-IT）， 由护士个案管理员在定期的家访期间实施， 艾滋病病例管理项目新接纳的客户 (n=222) 艾滋病，加利福尼亚州。 CAP-IT 是一种创新的、结构化的护理 评估和护理计划活动，允许标准化评估 客户需求和量身定制的 HAART 干预策略。 CAP-IT 是 与现行标准护理病例管理有显着不同 实践。研究目的是： 1) 测试标准化依从性是否良好 与标准护理相比，干预计划可改善 HAART 坚持率； 2) 测试是否有标准化的依从性干预计划， 与标准护理相比，影响 CD4 计数、病毒载量和 HAART 耐药性； 3) 测试依从性与 CD4 计数、病毒数量之间是否存在关系 负荷和HAART抵抗； 4) 测试是否有标准化的依从性干预 与标准护理相比，该计划会影响客户的生活质量；以及，5) 测试标准化依从干预计划是否与标准相比 护理，影响与健康相关的资源利用。文献综述 支持坚持 HAART 治疗问题的重要性以及 需要进一步研究重点关注干预措施的有效性 提高依从性和随后的健康相关结果。证据还在于 提供支持利用护士个案经理的可行性 提供基于家庭护理的依从性干预。