A nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention (EXTRA-CVD)

由护士主导的干预措施，旨在扩大艾滋病毒治疗级联以预防心血管疾病 (EXTRA-CVD)

• 批准号: 9763155
• 负责人: Hayden B Bosworth
• 金额: $ 9.26万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763155
• 关键词: AIDS/HIV problem; Adherence; Atherosclerosis; Attitude; Cardiac; Cardiovascular Diseases; Caring; Clinic; Comorbidity; Enrollment; Event; General Population; HIV; HIV antiretroviral; Health Personnel; Hyperlipidemia; Hypertension; Individual; Intervention; Methods; Modeling; Monitor; Nurses; Parents; Participant; Pharmaceutical Preparations; Play; Preventive therapy; Provider; Qualitative Methods; Risk Factors; Role; Viral; antiretroviral therapy; cardiovascular disorder prevention; cardiovascular disorder risk; care providers; extrinsic motivation; high risk; hypertension treatment; improved; intrinsic motivation; medical specialties; medication compliance; parent grant; prevent; therapy adherence; treatment adherence; treatment guidelines; uptake

Abstract In the HIV/AIDS treatment cascade model, people living with HIV (PLHIV) who are engaged in care are more likely to adhere to HIV Anti-Retroviral Therapy (ART) and achieve durable viral suppression. In order to achieve viral suppression, near perfect adherence to ART is required. Even though PLHIV are responsible for medication adherence, in HIV treatment guidelines, HIV care providers play an important role in encouraging and monitoring ART adherence. After achieving viral suppression, PLHIV and providers have an important opportunity to focus on preventing other non-AIDS comorbidities. Among non-AIDS defining conditions, PLHIV are at a higher risk for atherosclerotic cardiovascular disease (ASCVD) than the general population. It is therefore critical for these high-risk individuals to maintain optimal adherence to medications to reduce the likelihood of advanced atherosclerosis and subsequent cardiac events. However, little is known about medication adherence for treatment of ASCVD risk factors such as hypertension and hyperlipidemia for PLHIV who have achieved viral suppression. In this 3-year diversity supplement, the candidate proposes to use qualitative methods to explore intrinsic and extrinsic motivational factors that facilitate optimal hypertension and hyperlipidemia medication adherence among PLHIV who have achieved durable viral suppression and identify HIV healthcare provider attitudes and practice norms among other factors that impact intentions to monitor and encourage adherence to hypertension and hyperlipidemia medications in PLHIV who have achieved viral suppression. The candidate also proposes to use quantitative methods to assess medication adherence for hypertension and hyperlipidemia for participants enrolled in the parent study.

摘要 在艾滋病毒/艾滋病治疗级联模型中，艾滋病毒携带者(PLHIV)从事护理的人更多 有可能坚持艾滋病毒抗逆转录病毒疗法(ART)，实现持久的病毒抑制。为了实现 病毒抑制，近乎完美地坚持抗逆转录病毒治疗是必需的。即使PLHIV负责用药 遵守，在艾滋病毒治疗指南中，艾滋病毒护理提供者在鼓励和监测方面发挥重要作用 艺术坚守。在实现病毒抑制之后，PLHIV和提供者有一个重要的机会专注于 关于预防其他非艾滋病合并症。在非艾滋病定义的疾病中，PLHIV的风险更高 对于动脉粥样硬化性心血管疾病(ASCVD)来说，比普通人群更重要。因此，对这些人来说至关重要 高危个体保持最佳的药物依从性，以降低晚期癌症的可能性 动脉粥样硬化和随后的心脏事件。然而，对患者的用药依从性知之甚少。 高血压、高脂血症等ASCVD危险因素对实现病毒感染的PLHIV的治疗 压制。 在这份为期3年的多样性补充报告中，候选人建议使用定性的方法来探索内在和 促进最佳高血压和高脂血症用药依从性的外在动机因素 在已实现持久病毒抑制并确定艾滋病毒医疗保健提供者态度和 在影响监测和鼓励坚持高血压意向的其他因素中，实践规范 以及PLHIV中已实现病毒抑制的高脂血症药物。候选人还提议 使用定量方法评估参与者对高血压和高脂血症的服药依从性 参加了家长研究。