NURSING INTERVENTION TO IMPROVE ANTIVIRAL ADHERENCE

Yale University, New Haven CT

Investigators

Linked publications & trials

Abstract

DESCRIPTION (adapted from the Abstract): The Principal Investigator proposes to conduct a prospective randomized clinical trial of HIV- infected individuals (N=2000) to test the effectiveness of a home-based nursing intervention based on the adult education principles of Paole Freire and designed to improve adherence to highly active anti-retroviral therapies (HAART). The hone-based nursing intervention will be compared to standard nursing care provided in a ambulatory care setting. The adherence outcome will be measured using the medication event monitoring system (MEMS) data, self-report, and unannounced pill counts. Experimental participants will receive the home-based intervention weekly for twelve weeks, every other week for twelve weeks, and monthly for one year thereafter. Other specific aims are to: (1) describe the relationship between the home-based nursing intervention and biologic measures of clinical outcome (plasma quantitative HIV RNA levels and CD4 lymphocyte counts); (2) describe the relationship between the home-based nursing intervention and a subjective measure of clinical outcome (participant's perception of health stratus); and (3) explore the relationship between the home-based nursing intervention and contextual factors related to adherence (social support, trust in provider, and knowledge of the purpose of HAART). Data collections methods include face-to-face interviews, microcomputer monitoring technology, unannounced pill counts, and medical record abstraction at baseline through 6 months post intervention (Month 18).