INCENTIVES TO IMPROVE TREATMENT OUTCOME IN HIV AND IDUS

改善艾滋病毒和注射吸毒者治疗结果的激励措施

• 批准号: 6662118
• 负责人: Steven L Batki
• 金额: $ 17.92万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6662118
• 关键词: HIV infections; Medicare /Medicaid; behavioral /social science research tag; clinical research; clinical trials; comorbidity; disease /disorder proneness /risk; drug abuse chemotherapy; emergency care; endogenous opioid; health care cost /financing; health care service utilization; human subject; human therapy evaluation; injection /infusion; methadone; outcomes research; patient care management; psychological reinforcement; therapy compliance; urinalysis

DESCRIPTION: (Applicant?s Abstract) The overall goal of the proposed research study is to improve treatment outcomes for drug use and medical care among human immunodeficiency virus (HIV) infected injection drug users (IDUs) undergoing methadone treatment. Methadone maintenance treatment (MMT) is a widely applied and highly effective treatment available for IDUs who are opioid dependent, yet it has limitations. For example, while methadone treatment significantly reduces the use of heroin, it does not completely eliminate opiate use in all patients. Furthermore, the use of non-opiates such as stimulants, alcohol, and other drugs is not as robustly reduced in MMT patients as is the use of opiates. Continued drug use by HIV-infected IDUs increase the risk for other infectious diseases. Drug use may also cause problems with HIV health care by interfering with appointment keeping and adherence to medical regimens. It is therefore essential to find ways to improve the effectiveness of MMT with respect to both drug use and medical care in HIV-infected persons. The proposed study will consist of a six month randomized trial to test the efficacy of incentives in the form of contingent vouchers designed to improve the treatment outcome of HIV-infected MMT patients in the domains of drug use and HIV medical care. 150 HIV-infected MMT patients will be randomized to one of three treatment conditions: 1) a Drug Voucher group that will be given incentives to reinforce drug-free urine tests, 2) a Drug plus Medical Voucher group that will be given incentives to reinforce both drug-free urines and HIV "Medical Care Management" appointment keeping, and 3) a No Voucher control group that will receive no incentives. Participants in the study will be able to exchange vouchers for goods and services of their choice. The main outcomes will consist of drug use, medical appointment keeping, HIV and drug-related medical morbidity, and HIV and drug-related health care costs.

描述：（申请人的摘要） 拟议的研究的总体目标是改善治疗 人类免疫缺陷病毒（HIV）中药物使用和医疗的结果 受感染的注射吸毒者（IDU）接受美沙酮治疗。 美沙酮维护处理（MMT）是一种广泛应用且高效的 可用于阿片类药物依赖性的IDU，但有局限性的治疗方法。 例如，虽然美沙酮治疗大大减少了海洛因的使用，但 它并不能完全消除所有患者的鸦片使用。此外， 使用刺激剂，酒精和其他药物等非摄取物的使用不像 MMT患者的使用和使用鸦片使用量也可以降低。继续使用毒品 通过HIV感染的IDU增加了其他传染病的风险。吸毒 还可能通过干扰预约而引起艾滋病毒医疗保健问题 保持和遵守医疗方案。因此，必须找到 提高MMT在药物使用和 艾滋病毒感染者的医疗保健。 拟议的研究将包括一个六个月的随机试验，以测试 激励措施的功效以旨在改善的应急凭证的形式 艾滋病毒感染的MMT患者在药物使用域中的治疗结果 和艾滋病毒医疗保健。 150名HIV感染的MMT患者将被随机分为一个 在三个治疗条件中：1）将给出的药物凭证组 激励措施加强免毒尿液测试，2）药物加上医疗凭证 将有激励措施加强无药尿液和艾滋病毒的组 保存“医疗保健管理”，3）无凭证控制 将不会获得激励措施的小组。研究的参与者将能够 将优惠券换成他们选择的商品和服务。主要结果 将包括吸毒，医疗保存，艾滋病毒和与药物有关的 医疗发病率以及与艾滋病毒和毒品有关的医疗保健费用。