Mobile Health Application to Improve HIV Medication Adherence

提高艾滋病毒药物依从性的移动健康应用程序

• 批准号: 9273629
• 负责人: Susan E Ramsey
• 金额: $ 24.02万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-16 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9273629
• 关键词: Address; Adherence; American; Behavioral; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical; Data; Disease Progression; Feedback; Focus Groups; Future; Goals; HIV; HIV Infections; Health Personnel; Individual; Intervention; Interview; Longevity; Measures; Meta-Analysis; Modification; Morbidity - disease rate; Motivation; Participant; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Phase; Problem Solving; Process; Production; Public Health; Publishing; Randomized Controlled Trials; Research; Resistance development; Resources; Risk; Self Efficacy; Services; Testing; Time; Training; United States; Viral; Viral Load result; Virus; Work; antiretroviral therapy; base; clinical care; cost effective; follow-up; health application; improved; infancy; interest; mHealth; medication compliance; mobile application; mortality; motivational enhancement therapy; phase 1 study; phase 2 study; pill; portability; primary outcome; process repeatability; prototype; psychoeducation; public health relevance; resistant strain; skills; standard of care; success; therapy adherence; therapy development; trial comparing; viral transmission

 DESCRIPTION (provided by applicant): There are more than a million Americans who are infected with HIV. Highly effective antiretroviral therapy (ART) makes it possible for persons living with HIV (PLWH) to have longer, healthier lives. Despite treatment advances, only a quarter of PLWH successfully keep the virus under control. Medication non-adherence is a significant contributor to unsuccessful viral suppression. As a result, interventions targeting adherence have been developed, with most interventions demonstrating some degree of success in the short-term. However, the impact of these interventions is generally not sustained over time, and it is not feasible to deliver more intensive adherence interventions in most HIV treatment settings. As a result, there has been interest in developing efficacious electronically-delivered interventions. This work is still in its infancy, and there is a paucity of work that has been done to establish the efficacy of mobile health ART adherence applications. A mobile health application would maximize the portability of the intervention and allow for real-time adherence tracking and feedback and ready access to content or services to enhance adherence. The present proposal aims to develop and refine a mobile health ART adherence application and to conduct a preliminary randomized controlled trial (RCT) comparing a face-to-face ART adherence intervention followed by the mobile health ART adherence application (mARTAA) to the face-to-face adherence intervention alone, which approximates standard-of-care (SOC). The long-term goal of this line of research is to disseminate an efficacious, mobile health ART adherence application that can be integrated readily into clinical care. In Phase 1 of the proposed study, we will develop and refine mARTAA using an iterative process of piloting and modification based on data collected from pilot participants (n=20). Phase 2 (n=60) will consist of a preliminary RCT comparing mARTAA and SOC. Participants in the RCT will complete a baseline interview and follow-up interviews at 1, 3, 6, and 12 months. The primary outcome variable will be ART adherence based on electronic pill box data. We expect that, as a result of this project, we will have developed and demonstrated the efficacy of a mobile health application to improve ART adherence that can be disseminated easily into real-world clinical settings. Such an intervention holds the promise of improving HIV viral suppression, slowing disease progression, reducing HIV-related morbidity and mortality, decreasing the risk of HIV infection in others, and minimizing the production of treatment resistant strains of HIV.

 描述（由适用提供）：有超过一百万的美国人感染了艾滋病毒。高效的抗逆转录病毒疗法（ART）使患有艾滋病毒（PLWH）的人拥有更长，更健康的生活。尽管有治疗的进展，但只有四分之一的PLWH成功地控制了病毒。药物不遵守是导致病毒抑制失败的重要促进者。结果，已经制定了针对依从性的干预措施，大多数干预措施在短期内表现出一定程度的成功。但是，这些干预措施的影响通常不会随着时间的流逝而持续下去，并且在大多数HIV治疗环境中提供更密集的依从性干预措施是不可行的。结果，人们有兴趣开发有效的以电子方式干预措施。这项工作仍处于起步阶段，而且很少 是为了确定移动健康艺术依从性应用的效率。移动健康应用程序将最大程度地提高干预措施的可移植性，并允许实时依从性跟踪和反馈，并可以访问内容或服务以增强依从性。本提案旨在开发和完善移动健康艺术依从性应用程序，并进行初步的随机对照试验（RCT），以比较面对面的艺术依从性干预措施，然后进行移动健康艺术依从性应用程序（MARTAA）与单独的面对面依从性干预，这近似于标准的贴心（SOC）。这项研究系列的长期目标是传播一种有效的移动健康艺术依从性应用程序，该应用可以容易地集成到临床护理中。在拟议的研究的第1阶段中，我们将根据从试点参与者收集的数据进行试验和修改的迭代过程（n = 20），开发和完善Martaa。第2阶段（n = 60）将包括比较Martaa和SoC的初步RCT。 RCT的参与者将在1、3、6和12个月完成基线访谈和后续访谈。主要结果变量将是基于电子药盒数据的艺术依从性。我们预计，由于该项目，我们将开发并证明移动健康应用程序的效率，以提高可以轻松传播到现实世界中临床环境中的艺术依从性。这样的干预措施有望改善HIV病毒抑制，疾病缓慢的进展，降低与HIV相关的发病率和死亡率，降低其他人的HIV感染风险，并最大程度地减少抗治疗抗性HIV菌株的产生。

项目成果

Same-Day Associations Between Substance Use and Medication Nonadherence Among Persons Living with HIV.

艾滋病毒感染者当天药物使用与药物不依从之间的关联。

• DOI: 10.1177/1178221819878751
• 发表时间: 2019
• 期刊: Substance abuse : research and treatment
• 作者: Ramsey,SusanE;Ames,EvanG;Uber,Julia;Habib,Samia;Clark,Seth;Waldrop-Valverde,Drenna
• 通讯作者: Waldrop-Valverde,Drenna

A Preliminary Test of an mHealth Facilitated Health Coaching Intervention to Improve Medication Adherence among Persons Living with HIV.

• DOI: 10.1007/s10461-021-03342-5
• 发表时间: 2021-11
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Ramsey SE;Ames EG;Uber J;Habib S;Clark S;Waldrop D
• 通讯作者: Waldrop D