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Jennifer Cocohoba博士的K23奖的重新提交，她是加州大学旧金山分校的HIV药剂师和临床副教授。Cocohoba博士正在成为一名以患者为导向的研究领域的年轻研究者。她对基于证据的方法感兴趣，通过这些方法，药剂师可以提高慢性疾病，特别是艾滋病毒患者的药物依从性。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、定性和干介性研究，以了解和衡量药剂师对抗逆转录病毒依从性的影响；(2)在临床研究中应用先进的生物统计学方法；(3)发展独立的、以患者为导向的临床研究事业，研究药物依从性。为了实现这些目标，Cocohoba博士组建了一个指导团队，其中包括一名主要导师Ruth Greenblatt博士，她是妇女跨机构艾滋病毒研究旧金山站的首席研究员，负责研究艾滋病毒对妇女的影响；共同导师，加州大学旧金山分校艾滋病预防研究中心的副教授Mallory Johnson博士，他进行了干预研究，以提高抗逆转录病毒治疗的依从性；以及两位科学顾问：Peter Bacchetti博士，研究设计和最先进的生物统计方法方面的专家，以及Megan Comfort博士，定性研究方面的专家。Cocohoba博士的长期目标是提高药剂师在提高药物依从性方面的影响。本应用程序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（目的1）；了解药师-患者依从性咨询动态（目标2）；并通过开展一项基于信息-动机-行为模型的药剂师提供电话咨询干预的试点研究来衡量咨询对艾滋病毒治疗结果的影响。(3)为目标。这项研究将成为一项随机介入试验的基础，该试验将在K奖结束前以R01拨款申请的形式提交。