ADHERENCE TO ANTIRETROVIRAL THERAPY: A CONTROLLED TRIAL

描述：(摘自申请者摘要)最新发展高度 主动抗逆转录病毒(AR)疗法代表着 艾滋病毒感染的治疗。不幸的是，障碍使遵守变得困难。 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患者和提供者的关系是一种 坚持的决定因素。在对其他慢性病患者的研究中， 当患者接受培训时，与坚持有关的健康结果会得到改善 更多地参与医疗决策。患者的参与是 越来越多地倡导艾滋病毒患者提高依从性；然而， 参与对遵守ARS的影响从未被直接评估过。 这项研究的具体目的是：1)测试干预是否会对 增加HIV感染患者对AR决策的参与度 治疗提高了他们的依从性和病毒载量。基于我之前的模型 患者参与，我将开发一种干预措施，培训患者 艾滋病毒参与决策，并提供反馈和跟踪 为期12周。然后，我将使用随机对照试验来测试这一点 对在北卡罗来纳大学开始新的AR的艾滋病毒感染患者的干预 传染病。2)评估干预的作用机制 旨在提高患者对医疗决策的参与度 坚持不懈。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 访问和患者参与对依从性的影响。这项研究是 旨在以我之前的研究为基础，促进我从 从博士后研究员到独立调查员。执行建议的 学习将帮助我实现我的职业目标：作为一名 临床研究人员通过评估提高AR治疗依从性的因素 2)加深对患者之间关系的理解 参与并坚持慢性药物治疗。

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.