Improving the diagnosis and treatment of medication adherence problems in HIV

改善艾滋病毒药物依从性问题的诊断和治疗

• 批准号: 8012911
• 负责人: IRA B WILSON
• 金额: $ 19.5万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8012911
• 关键词: Adherence; Attitude; Award; Behavior; Behavioral; Belief; CD4 Lymphocyte Count; Cardiovascular Diseases; Caring; Chronic; Chronic Care; Clinical; Clinical Trials; Clinical and Translational Science Awards; Code; Cognitive; Collaborations; Communication; Comorbidity; Complex; Counseling; Data Analyses; Diabetes Mellitus; Diagnosis; Discipline; Disease; Electronic drug monitoring; Electronics; Environment; Exhibits; Goals; HIV; Health; Health Personnel; Individual; Intervention; Interview; Knowledge; Learning; Link; Manuscripts; Medical center; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Mind; Mission; Modeling; Monitor; Morbidity - disease rate; Nature; Office Visits; Outcome; Outpatients; Participant; Patient Care; Patient Self-Report; Patients; Perception; Persons; Pharmaceutical Preparations; Physicians; Provider; Publishing; Quality of Care; Regimen; Research; Research Methodology; Research Personnel; Role; Sampling; Science; Series; Source; Staging; Testing; Thinking; Time; Training; Translational Research; Universities; Viral Load result; Visit; Work; abstracting; antiretroviral therapy; care systems; clinical care; compliance behavior; diagnosis quality; effective intervention; electronic data; forgetting; improved; interest; medication compliance; motivational enhancement therapy; multidisciplinary; next generation; novel; patient oriented research; pill; prevent; programs; public health relevance; response; skills; success; therapy adherence

DESCRIPTION (provided by applicant): This proposed renewal of Dr. Wilson's K24 builds on the strong record of success achieved during the first 6 years of this award. Since the start of his K24 in 2003 he has mentored 52 individuals, including 19 whom he is currently mentoring. During this time his mentees have produced 26 first author published manuscripts and 19 first author abstracts. Eight mentees have gone on to be awarded K23's, and 3 to receive R-series awards. The research environment at Tufts Medical Center and Tufts University is highly conducive Dr. Wilson's patient-oriented research and provides several different sources for mentees, and as of 2008 includes a Clinical Translational Science Award (CTSA). Dr. Wilson is Co-PI of the Tufts CTSA and a Director of the Tufts Clinical and Translational Research Portal, which means that the scope of his mentoring is now University wide. The patient oriented research of Dr. Wilson and his mentees focuses on problems with medication adherence in persons with HIV. Despite the availability of one pill once daily treatment for HIV, poor adherence with HIV antiretroviral therapy (ART) clearly continues to be a problem for HIV care providers worldwide. It is also clear that non-infectious comorbidity such as diabetes and cardiovascular disease is increasingly common in persons with HIV, and that medications required for these other conditions further complicate patients' adherence efforts. Progress on this important global problem requires that we be able to quickly and inexpensively identify patients with adherence problems, and that we have interventions to implement in response that target patients' individual needs. That is, we need to both better diagnosis and better treatment. The long term goal of this research is to link the accurate and timely diagnosis of medication adherence problems with customized treatments that are patient and medication specific. The overall research objective of this K24 is to complete a series of 5 significant and novel Aims, all of which focus on improving the quality of diagnosis and treatment of medication adherence problems in persons with HIV. The overall mentoring objective of this K24 is to develop researchers who not only have the skills to develop, implement, and publish hypothesis driven, patient-oriented research, but who understand the importance of bringing a multi-method, multi-disciplinary approach to clinical and translational research problems. In his mentoring Dr. Wilson emphasizes the importance of tailoring research methods to the nature of the problem of interest, even if that means learning new methods or developing collaborations with others from other disciplines familiar with those methods. The proposed research is relevant to the NIH's mission because it attempts to improve the quality of care for patients with a prevalent and serious, but highly treatable, chronic condition, and because the lessons learned from this HIV-related work are directly applicable to the care patients with other chronic conditions. PUBLIC HEALTH RELEVANCE: Improving the health outcomes of persons with chronic conditions generally requires lifelong adherence with effective medications, which most patients find difficult. The patient-oriented research proposed in this K24 focuses broadly on improving both the diagnosis and treatment of medication adherence problems in persons with HIV. In addition, the mentoring plan that Dr. Wilson will implement will contribute to the training of the next generation of researchers to continue this important multidisciplinary work. While this K24 focuses on HIV, the lessons learned from this work are directly applicable to the care patients with other chronic conditions.

描述（由申请人提供）：威尔逊博士的K24的拟议更新建立在该奖项的前6年取得的成功的良好记录。自2003年K24成立以来，他已经指导了52人，其中包括他目前正在指导的19人。在此期间，他的学员产生了26第一作者发表的手稿和19第一作者摘要。8名学员获得了K23奖，3名获得了R系列奖。塔夫茨医学中心和塔夫茨大学的研究环境非常有利于威尔逊博士以患者为导向的研究，并为学员提供了几个不同的来源，截至2008年，包括临床转化科学奖（CTSA）。威尔逊是塔夫茨CTSA的共同PI和塔夫茨临床和转化研究门户网站的主任，这意味着他的指导范围现在是整个大学。 Wilson博士和他的学员以患者为导向的研究重点是艾滋病毒感染者的药物依从性问题。尽管每天一次服用一粒药丸治疗艾滋病毒，但艾滋病毒抗逆转录病毒疗法（ART）的依从性差显然仍然是全世界艾滋病毒护理提供者的一个问题。同样清楚的是，非感染性合并症，如糖尿病和心血管疾病，在艾滋病毒感染者中越来越常见，而这些其他疾病所需的药物治疗进一步使患者的依从性工作复杂化。在这一重要的全球性问题上取得进展，要求我们能够快速、廉价地识别出有依从性问题的患者，并针对患者的个人需求采取干预措施。也就是说，我们需要更好的诊断和更好的治疗。这项研究的长期目标是将药物依从性问题的准确、及时诊断与针对患者和药物的定制治疗联系起来。K24的总体研究目标是完成一系列5个重要和新颖的目标，所有这些目标都集中在提高艾滋病毒感染者药物依从性问题的诊断和治疗质量。该K24的总体指导目标是培养研究人员，他们不仅具有开发，实施和发布假设驱动，以患者为导向的研究的技能，而且了解将多方法，多学科方法引入临床和转化研究问题的重要性。在他的指导下，威尔逊博士强调了根据感兴趣的问题的性质定制研究方法的重要性，即使这意味着学习新方法或与熟悉这些方法的其他学科的其他人进行合作。拟议的研究与NIH的使命相关，因为它试图提高对患有流行和严重但高度可治疗的慢性病患者的护理质量，并且因为从这项HIV相关工作中吸取的教训直接适用于其他慢性病患者的护理。 公共卫生关系：改善慢性病患者的健康结果通常需要终身坚持有效的药物治疗，大多数患者发现这很困难。K24中提出的以患者为导向的研究主要集中在改善艾滋病毒感染者药物依从性问题的诊断和治疗。此外，威尔逊博士将实施的指导计划将有助于培训下一代研究人员继续这一重要的多学科工作。虽然K24的重点是艾滋病毒，但从这项工作中吸取的经验教训直接适用于患有其他慢性病的护理患者。