ADHERENCE TO ANTIRETROVIRAL THERAPY: A CONTROLLED TRIAL

描述：（来自申请人的摘要）高度分散的聚合物的最近发展。 积极的抗逆转录病毒（AR）治疗代表了一个巨大的飞跃， 治疗HIV感染。不幸的是，障碍使遵守困难。 不充分的坚持往往会产生病毒耐药性和治疗失败。 因此，依从性已成为方案疗效的关键决定因素。 几项研究已经确定了病人与提供者的关系， 坚持的决定因素。在对其他慢性病患者的研究中， 当患者接受培训， 更多地参与医疗决策。患者参与是 越来越多地提倡艾滋病毒感染者加强依从性;然而， 参与对AR依从性的影响从未被直接评估。 本研究的具体目的是：1）测试是否干预， 增加艾滋病毒感染者参与有关AR的决策 治疗改善了他们的依从性和病毒载量。根据我之前的模型 患者参与，我将开发一种干预措施， 艾滋病毒参与决策，并提供反馈和后续行动， 12周的时间。然后我将使用随机对照试验来验证这一点 在2015年开始新的AR的HIV感染患者中进行干预 传染病2)评估干预措施的作用机制 旨在增加患者参与医疗决策， 坚持。我将评估干预对患者的影响 参与以及患者和医生对医疗服务的满意度 访视以及患者参与对依从性的影响。这项研究是 旨在建立在我之前的研究基础上， 从博士后到独立调查员执行提议的 学习将帮助我实现我的职业目标：实现独立， 临床研究者通过评估因素来提高AR治疗依从性 （2）加深对患者关系的理解。 参与和坚持慢性药物治疗。

DESCRIPTION: (from Applicant's Abstract) The recent development of highly active antiretroviral (AR) therapy represents a tremendous leap forward in treatment of HIV infection. Unfortunately, barriers make adherence difficult. Inadequate adherence often produces viral resistance and treatment failure. Consequently, adherence has become a critical determinant of regimen efficacy. Several studies have identified the patient-provider relationship as a determinant of adherence. In studies of patients with other chronic illnesses, health outcomes linked to adherence are improved when patients are trained to participate more in medical decision-making. Patient participation is increasingly advocated for patients with HIV to enhance adherence; however, the effect of participation on adherence to ARs has never been directly assessed. The specific aims of the study are: 1) To test whether an intervention to increase HIV-infected patients' participation in decision-making regarding AR therapy improves their adherence and viral load. Based on my prior model of patient participation, I will develop an intervention that trains patients with HIV to participate in decision-making and provides feedback and follow-up over a 12 week period. I will then use a randomized controlled trial to test this intervention among HIV-infected patients who are starting a new AR at UNC Infectious Diseases. 2) To evaluate the mechanisms of action of an intervention aimed at increasing patient participation in medical decision-making on adherence. I will assess the impact of the intervention on patient participation as well as patient and physician satisfaction with the medical visit and the impact of patient participation on adherence. The study is designed to build upon my prior research and facilitate my transition from post-doctoral fellow to independent investigator. Carrying out the proposed study will help me to meet my career goals: to achieve independence as a clinical researcher by evaluating factors to improve adherence to AR therapy and 2) to develop a deeper understanding of the relationship between patient participation and adherence to chronic medical therapy.