Intelligent Mobil Antiretroviral Adherence Coach

描述（由申请人提供）：技术开发：我们建议开发智能移动抗逆转录病毒依从性教练（IMAAC），这是一个易于使用的移动软件系统，用于增强抗逆转录病毒药物的依从性。IMAAC将在行业标准的个人数字助理（pda）和手机上运行，它结合了基于认知行为原则的依从性知识库、智能交互和推理能力，以及适合每个用户的患者模型。它将学习个人的行为反应模式，并提供已知的替代解决方案，以改善或加强药物依从性。该产品的创新之处在于能够适应用户个体特征，基于认知行为原理生成个性化的智能交互引导。这将增强其对行为改变的长期维护的效用。在标准pda和移动电话上交付应用程序可以最大限度地降低成本。它还可以帮助用户保护隐私，因为它不会引起携带专门设备的人的注意。第一阶段的工作将侧重于IMAAC的可行性和可接受性。在第二阶段，我们将充分开发该系统，并将其疗效与接受标准治疗的对照组患者进行比较。技术/产品/服务的使用：截至2005年底，美国估计有1205,969人感染艾滋病毒/艾滋病。到1998年，接受抗逆转录病毒治疗的患者人数增加到71%，但在第二次随访中，只有53%的人报告接受了抗逆转录病毒治疗，这表明尽管美国大多数接受艾滋病毒治疗的人都接受了抗逆转录病毒治疗，但对很大一部分人来说，继续使用抗逆转录病毒治疗存在问题。这是令人不安的，因为有大量证据表明抗逆转录病毒疗法降低了与艾滋病毒/艾滋病相关的发病率和死亡率。研究发现，行为干预在增强对复杂的抗逆转录病毒药物治疗方案的依从性方面是成功的。行为干预成功的原因之一是个人在参与行为干预时得到的反馈和支持，以及支持生活方式改变的信息和策略。以前基于行为的项目的问题在于它们是有时间限制的，而抗逆转录病毒疗法的坚持对艾滋病毒感染者来说是一个长期和终身的努力。开发一种基于认知行为原则的创新系统，这种系统可以根据个人情况量身定制，使该计划能够真正适应个人的变化，这可能会促进并保持不同艾滋病毒感染人群的显著依从性。Performigence公司的技术提供了基于认知-行为原则的依从性知识库的表示能力，并提供智能交互，以便用户的生理模型可以被理解，指导可以通过行为和生活方式智能进行调整。IMAAC为个人提供了一种方便和复杂的方法，使他们能够获得经验验证的抗逆转录病毒治疗依从性方法，这些方法不断根据他们的需求和情况量身定制。对公司的好处：一旦原型开发完成，将寻求第二期资金来完成系统的开发和测试功效。在STTR项目第一和第二阶段的资助下，Performigence将能够通过一个结合了便携性、智能交互、易用性和低成本消费电子产品与认知行为原则的系统，解决艾滋病毒阳性个体的抗逆转录病毒治疗依从性问题。虽然该系统旨在改善艾滋病毒阳性人群的抗逆转录病毒治疗依从性，但该项目的公共卫生意义相当高，因为该系统可以很容易地进行修改，以解决严重依赖生活方式改变的其他慢性疾病，如糖尿病和肥胖。这两种疾病都增加了美国所有年龄和种族群体的发病率和死亡率。产品将如何商业化：将使用performance的专有软件技术作为IMAAC开发的基础。该系统将销售给医疗、工业、研究和消费市场。预计IMAAC将被消费者和医生广泛接受和使用。公共卫生相关性：开发一种可与电话或个人数字助理（pda）等手持设备一起使用的系统，该系统可针对个人量身定制，提供激励信息、行为线索、事实信息、互动指导和强化，可能会增加抗逆转录病毒治疗的依从性，从而降低与艾滋病毒/艾滋病相关的发病率和死亡率。此外，该系统将是一种具有成本效益的方法，为医疗提供者提供信息，以加强治疗和护理。可以对这种系统进行修改，以满足需要改变行为和生活方式的其他慢性病的需要，从而使该系统的用途广泛。

DESCRIPTION (provided by applicant): Technology Developed: We propose to develop the Intelligent Mobile Antiretroviral Adherence Coach (IMAAC), which is an easy- to-use, mobile software system for enhancing adherence to antiretroviral medication. The IMAAC, which will run on industry standard personal digital assistants (PDAs) and cell phones, combines an adherence knowledgebase founded on cognitive-behavioral principals, intelligent interaction and reasoning capabilities, and a patient model adapted for each individual user. It will learn an individual's behavioral response patterns and provide alternative solutions known to improve or enhance medication adherence. The innovation of this product is its ability to adapt to individual user characteristics and generate personalized intelligent interactive guidance based on cognitive-behavioral principles. This will enhance its utility for long-term maintenance of behavior change. The delivery of the application on standard PDAs and cell phones minimizes costs. It also helps users maintain privacy by not drawing the attention a person may get carrying a specialized device. Phase I efforts will focus on the feasibility and acceptability of the IMAAC. In Phase II, we will fully develop the system and compare its efficacy to a control group of patients receiving standard-of-care. Uses of Technology/Products/Service: At the end of 2005, an estimated 1,205,969 persons in the United States were living with HIV/AIDS. By 1998, the number of patients ever receiving ART increased to 71%, however only 53% of these individuals reported receiving antiretroviral therapy (ART) during a second follow-up interview suggesting that while most individuals receiving care for HIV in the United States have taken ART, continuing its use is problematic for a significant proportion of individuals. This is troubling because there is overwhelming evidence that ART reduces morbidity and mortality associated with HIV/AIDS. Research has found that behavioral interventions are successful at enhancing adherence to complicated antiretroviral medication regimens. One of the reasons behavioral interventions are successful is the feedback and support individuals get while they are engaging in a behavioral intervention along with information and strategies to support lifestyle changes. The problem with previous behaviorally-based programs is that they are time limited, whereas ART adherence is a long-term and life-long endeavor for individuals infected with HIV. Developing an innovative system that is based on cognitive-behavioral principles that can be tailored to an individual so that the program actually adapts to individual changes over time is likely to facilitate and maintain significant adherence among diverse HIV infected populations. Performigence Corporation's technology provides the capability to represent an adherence knowledgebase based on cognitive-behavioral principles and deliver intelligent interaction so that the user's physiological model can be understood and the guidance can be adapted through behavioral and life style intelligence. The IMAAC offers a convenient and sophisticated method for individuals to access empirically validated methods of ART adherence that are continually tailored to their needs and circumstances. Benefit to Company: Once the prototype is developed, Phase II funds will be sought after to complete development and test the efficacy of the system. With Phase I and Phase II funding from the STTR program, Performigence will be able to address ART adherence among HIV-positive individuals with a system that combines portability, intelligent interaction, ease of use, and low cost of consumer electronics with cognitive-behavioral principles. While this system is being designed to improve ART adherence among HIV-positive populations, the public health significance of this project is quite high because this system can be easily modified to address other chronic conditions that rely heavily on lifestyle changes such as diabetes and obesity. Both conditions increase morbidity and mortality across all age and ethnic groups in the United States. How Product Will Be Commercialized: Performigence's proprietary software technology will be used as the foundation for IMAAC development. The system will be sold to medical, industrial, research and consumer markets. It is anticipated that the IMAAC will have widespread uptake and use by consumers as well as physicians. PUBLIC HEALTH RELEVANCE: Developing a system that can be used with hand-held devices like telephones or personal digital assistants (PDAs) that can be tailored to an individual to provide motivational messages, behavioral cues, factual information, interactive guidance and reinforcement would likely increase antiretroviral adherence, thereby reducing morbidity and mortality associated with HIV/AIDS. Additionally, the system would be a cost-effective method to provide information to medical providers to enhance treatment and care. Modifications to such a system could be made to meet the needs of other chronic diseases that require behavioral and lifestyle changes, making the utility of the system wide-ranging.