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: 8240545
• 负责人: Jennifer Marie Cocohoba
• 金额: $ 16.21万
• 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 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8240545
• 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）：这是艾滋病毒药剂师兼加州大学旧金山分校的艾滋病毒药剂师兼副临床教授珍妮弗·科科巴巴（Jennifer Cocohoba）博士的重新提交。 Cocohoba博士正在建立自己的年轻研究者，从事以患者为导向的研究。她对基于证据的方法感兴趣，通过这些方法，药剂师可以改善慢性疾病的药物依从性，特别是对艾滋病毒患者。该K23奖将为Cocohoba博士提供必要的支持，以实现以下目标：（1）进行定量，定性和介入性研究，以了解和衡量药剂师对药剂师对抗逆转录病毒依从性的影响； （2）在临床研究中实施先进的生物统计学方法； （3）开发独立的，以患者为导向的临床研究职业，研究药物依从性。 为了实现这些目标，Cocohoba博士组建了一个由主要导师组成的指导团队，由一名主要导师露丝·格林布拉特（Ruth Greenblatt）博士，他是妇女妇女间艾滋病毒艾滋病毒研究的旧金山遗址的首席研究员，他对艾滋病毒对妇女的影响进行了研究； UCSF艾滋病预防研究中心副教授Mallory Johnson博士Mallory Johnson博士进行了介入研究以改善抗逆转录病毒依从性；和两位科学顾问：研究设计和国家生物统计学方法的专家Peter Bacchetti博士，以及定性研究专家Megan Comfort博士。 Cocohoba博士的长期目标是增强药剂师对改善药物依从性的影响。该应用的目的是评估与收到药剂师依从性咨询有关的多个社会人口统计学和药房因素（AIM 1）；了解药剂师 - 患者依从性咨询动态（AIM 2）；并通过基于信息动机行为模型对药剂师进行的电话咨询干预进行试点研究来衡量咨询对艾滋病毒治疗结果的影响。 （目标3）。这项研究将构成一项随机介入试验的基础，该试验将在k奖结束之前在R01赠款申请中提交。 公共卫生相关性：迫切需要开发简单的方法来利用新颖的人力资源和物理资源来提高对抗逆转录病毒疗法的依从性。药剂师仍然是艾滋病毒治疗倡导的大型，未开发的资源。吸引药剂师有效地遵守依从性，可能会改善HIV治疗效果并降低HIV病毒抗性和传播。