Beyond Pill-Counting: Effect of Pharmacist Counseling on Antiretroviral Adherence

超越药丸计数：药剂师咨询对抗逆转录病毒药物依从性的影响

• 批准号: 8046407
• 负责人: Jennifer Marie Cocohoba
• 金额: $ 16.6万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8046407
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adherence; Adopted; Adverse effects; Advocacy; Advocate; Ancillary Study; Anti-Retroviral Agents; Antiretroviral resistance; Applications Grants; Area; Behavior; Behavioral Model; Biostatistical Methods; CD4 Lymphocyte Count; California; Chronic Disease; Clinic; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Communication; Communities; Counseling; Data; Effectiveness; Enrollment; Environment; Future; Goals; HIV; HIV Seropositivity; Healthcare; Healthcare Systems; Human; Human Resources; Immune; Intervention; Interview; K-Series Research Career Programs; Measures; Medication Errors; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Mission; Modeling; Monitor; Morbidity - disease rate; Motivation; Outcome; Patients; Pattern; Persons; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Physicians; Pilot Projects; Play; Positioning Attribute; Principal Investigator; Privacy; Qualitative Research; Randomized; Recruitment Activity; Regimen; Reporting; Research; Research Design; Research Institute; Research Methodology; Research Personnel; Resources; Role; San Francisco; Signal Transduction; Site; Structure; System; Telephone; Testing; Training; Translational Research; Treatment Effectiveness; Treatment Efficacy; Treatment outcome; Trust; Universities; Veterans; Viral Load result; Visit; Woman; Work; antiretroviral therapy; base; career; cohort; compliance behavior; design; evidence base; experience; follow-up; improved; interest; medication compliance; meetings; mortality; novel; patient oriented; patient oriented research; pill; professor; public health relevance; social; transmission process; viral resistance

DESCRIPTION (provided by applicant): This is a resubmission for a K23 award for Dr. Jennifer Cocohoba, an HIV Pharmacist and Associate Clinical Professor at the University of California, San Francisco. Dr. Cocohoba is establishing herself as a young investigator in patient-oriented research. She is interested in evidenced-based methods by which pharmacists can improve medication adherence for chronic diseases, particularly for patients with HIV. This K23 award will provide Dr. Cocohoba with the necessary support to accomplish the following goals: (1) to conduct quantitative, qualitative, and interventional studies that seek to understand and measure the impact pharmacists have on antiretroviral adherence; (2) to implement advanced biostatistical methods in clinical studies; and (3) to develop an independent, patient-oriented, clinical research career studying medication adherence. To achieve these goals, Dr. Cocohoba has assembled a mentoring team comprised of a primary mentor, Dr. Ruth Greenblatt, principal investigator of the San Francisco site of the Women's Interagency HIV Study, who conducts research on the effects of HIV on women; a co-mentor, Dr. Mallory Johnson, Associate Professor at the UCSF Center for AIDS Prevention Studies who conducts interventional studies to improve antiretroviral adherence; and two scientific advisors: Dr. Peter Bacchetti, an expert on study design and state- of-the-art biostatistical methods, and Dr. Megan Comfort, an expert in qualitative research. Dr. Cocohoba's long-term goal is to enhance the impact pharmacists have on improving adherence to medications. The objective of this application is to assess the multiple sociodemographic and pharmacy factors associated with receipt of pharmacist adherence counseling (Aim 1); to understand the pharmacist- patient adherence counseling dynamic (Aim 2); and to measure the impact counseling has on HIV treatment outcomes by conducting a pilot study of a pharmacist-delivered, telephone counseling intervention based on the Information-Motivation-Behavior model. (Aim 3). This research will form the basis of a randomized interventional trial that will be submitted in an R01 grant application before the end of the K award. PUBLIC HEALTH RELEVANCE: There is a critical need to develop simple methods that utilize novel human and physical resources to improve adherence to antiretroviral therapy. Pharmacists remain a large, untapped resource for HIV treatment advocacy. Engaging pharmacists to effectively counsel on adherence may result in an improvement in HIV treatment effectiveness and reduction in HIV viral resistance and transmission.

描述（由申请人提供）：这是为弗朗西斯科加州大学的HIV药剂师和副临床教授Jennifer Cocohoba博士重新提交的K23奖。Cocohoba博士正在建立自己作为一个年轻的研究人员在以病人为导向的研究。她对循证方法感兴趣，通过这些方法，药剂师可以提高慢性病的药物依从性，特别是艾滋病毒感染者。该K23奖项将为Cocohoba博士提供必要的支持，以实现以下目标：（1）进行定量，定性和干预性研究，以了解和衡量药剂师对抗逆转录病毒药物依从性的影响;（2）在临床研究中实施先进的生物统计方法;和（3）发展一个独立的，以病人为导向的，临床研究的职业生涯研究药物的依从性。 为了实现这些目标，Cocohoba博士组建了一个指导小组，由主要导师Ruth Greenblatt博士组成，她是妇女机构间艾滋病毒研究旧金山站点的首席研究员，负责研究艾滋病毒对妇女的影响;共同导师马洛里约翰逊博士是加州大学旧金山分校艾滋病预防研究中心的副教授，负责进行干预性研究，以提高抗逆转录病毒治疗的依从性;以及两位科学顾问：研究设计和最先进的生物统计方法专家Peter Bacchetti博士和定性研究专家Megan Comfort博士。 Cocohoba博士的长期目标是加强药剂师对改善药物依从性的影响。本申请的目的是评估与接受药剂师依从性咨询相关的多种社会人口统计学和药学因素（目标1）;了解药剂师-患者依从性咨询动态（目标2）;并通过基于信息-动机-行为模型对药剂师提供的电话咨询干预进行试点研究，测量咨询对HIV治疗结果的影响。(Aim 3）。这项研究将构成一项随机干预性试验的基础，该试验将在K奖结束前提交R 01资助申请。 公共卫生关系：迫切需要开发利用新的人力和物力资源的简单方法，以提高抗逆转录病毒疗法的依从性。药剂师仍然是艾滋病毒治疗宣传的一个巨大的、尚未开发的资源。让药剂师有效地就依从性提供咨询，可能会提高艾滋病毒治疗的有效性，减少艾滋病毒的耐药性和传播。