MEDICATION SUPERVISION AMONG HIV-INFECTED WITH COGNITIVE DEFICIT

Columbia University Health Sciences, New York NY

Investigators

Linked publications & trials

Abstract

HIV dementia has become the most common cause of dementia among young people. With an estimated 1.5 million people in the U.S. infected with HIV, there is a clear need to better define the relationship between advanced HIV infection and cognitive impairment. This will allow us to identify who will develop trouble with their thinking, help us discuss the course of the illness with patients and their families, and help us design treatment strategies. It is also important to determine the extent to which cognitive or motor impairment interfere with patients' ability to take medications. State-of-the-art HIV care now involves quite complex medication regimens. At this point, it is important to document the extent to which these deficits interefere with medication adherence. Also, it is important to develop and test models for increasing medication management supervision among patients with demonstrated inability to take medicines reliably. This study will examine neuropsychological status and competence in taking medications among a group of HIV+ people, who either meet criteria for or are at risk for AIDS (CD4<300), or who report cognitive deficits. Those whose neuropsychological and medication management profiles suggest impairment severe enough to interfere with medication adherence will be advised of the deficit. In addition, their primary care physicians will be notified of this deficit and will also be sent a recommendation and referral for increasing medication supervision for the patient. The referral will consist of a VNS (Visiting Nurses Service) contact. Physician referral, patient/information report, and VNS records will then be consulted to determine if medication supervision has increased.