P1042S (VERSION 10) COGNITIVE, BEHAVIORAL AND PSYCHOSOCIAL CORRELATES OF MED

P1042S（版本 10）医学的认知、行为和心理社会相关性

• 批准号: 7374986
• 负责人: William Thomas Shearer
• 金额: $ 0.49万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374986
• 关键词: P1042S; VERSION; 10; COGNITIVE; BEHAVIORAL

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In recent years, medication adherence has become a critical issue for HIV-infected children and adolescents because of drug resistance and the increased complexity of treatment regimens. In antiretroviral clinical trials, non- adherence to medication complicates our ability to measure the effectiveness of new drugs, and the lower response rate observed in children compared to adults is partially explained by problems with adherence. Medication adherence becomes increasingly problematic during adolescence. The growing population of preteens and adolescents with perinatally acquired HIV infection demands an understanding of factors that influence medication adherence. Effective interventions that promote adherence and can be integrated into both clinical care and research need to be developed. Clinicians should understand what factors influence an adolescent's ability to follow a complex treatment regimen before therapy is initiated. Primary study objectives are: 1)To assess the relationship of age, cognitive, behavioral, and psychosocial, functioning (including language, memory, attention, and academic skills) with adherence to medication regimens, as measured by self-report and pill count.; 2) To assess the relationship of age, cognitive, behavioral, and psychosocial functioning with the degree of responsibility for taking medications placed on participants, as measured by caregiver and self-report questionnaires. Secondary objectives are: 1) To characterize cognitive, behavioral, and psychosocial functioning in children and adolescents with perinatally acquired HIV infection; 2) To correlate cognitive, behavioral, and psychosocial functioning with virologic and disease variables; 3) To assess interactions between participants? cognitive status and the complexity of their medication regimens in predicting adherence, as measured by self-report and pill count; 4) To assess the ability of baseline cognitive, behavioral, and psychosocial variables to predict adherence at a later time point (24 and 48 weeks following enrollment); 5) To assess the correlation of self-report and pill count measures of adherence; 6) To assess the stability of adherence over time as measured by self-report and pill counts; 7) To correlate measures of adherence with disease severity as measured by viral load, CDC disease category and CD4 counts, and to assess whether the association between adherence and disease severity is stable over time; and 8) To develop a predictive model that could be used by clinicians to identify children and adolescents who are more likely to have problems adhering to their antiretroviral medication regimens.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。近年来，由于耐药性和治疗方案日益复杂，药物依从性已成为感染艾滋病毒的儿童和青少年的一个关键问题。在抗逆转录病毒临床试验中，不坚持用药使我们衡量新药有效性的能力变得复杂，在儿童中观察到的应答率低于成人，部分原因是坚持用药的问题。药物依从性在青春期变得越来越成问题。不断增长的围产期获得性HIV感染的青少年和青少年人口需要了解影响药物依从性的因素。需要制定有效的干预措施，促进依从性，并可纳入临床护理和研究。在开始治疗之前，临床医生应该了解哪些因素影响青少年遵循复杂治疗方案的能力。主要研究目的是：1）评估年龄、认知、行为和心理社会功能（包括语言、记忆、注意力和学术技能）与药物治疗方案依从性的关系，通过自我报告和药丸计数进行测量; 2)评估年龄、认知、行为和心理社会功能与参与者服药责任程度的关系，通过护理人员和自我报告问卷进行测量。次要目的是：1）描述围产期获得性HIV感染儿童和青少年的认知、行为和社会心理功能; 2）将认知、行为和社会心理功能与病毒学和疾病变量相关联; 3）评估参与者之间的相互作用？认知状态和药物治疗方案的复杂性在预测依从性方面，通过自我报告和药丸计数进行测量; 4）评估基线认知、行为和心理社会变量在以后时间点预测依从性的能力（入组后24周和48周）; 5）评估自我报告和药丸计数依从性测量的相关性; 7）将依从性的测量与疾病严重程度相关联，如通过病毒载量、CDC疾病类别和CD 4计数测量的，并评估依从性和疾病严重程度之间的关联是否随时间稳定;和8）开发一个可供临床医生使用的预测模型，以确定哪些儿童和青少年更有可能在坚持抗逆转录病毒药物治疗方案方面存在问题。