Cell Phone Technology Targeting ART and Naltrexone Adherence and Alcohol Use

针对 ART 和纳曲酮依从性以及饮酒的手机技术

• 批准号: 8725030
• 负责人: Suzette V Glasner-Edwards
• 金额: $ 16.3万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8725030
• 关键词: AIDS prevention; Adherence; Adult; Affect; Aftercare; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Anti-Retroviral Agents; Behavior Therapy; Behavioral; Car Phone; Cellular Phone; Clinical; Clinical Trials; Cognitive Therapy; Communities; Complement; Coping Skills; Cost Savings; Coupled; Data; Development; Drug abuse; Evaluation; Evidence based treatment; Feedback; Frequencies; HIV; HIV Infections; HIV risk; Health; Healthcare; Individual; Infection; Intervention; Interview; Investigation; Measures; Medical; Medication Management; Naltrexone; Outcome; Participant; Pharmaceutical Preparations; Pharmacotherapy; Phase; Population; Protocols documentation; Public Health; Randomized Clinical Trials; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Research Design; Research Personnel; Risk; Risk Behaviors; Self Efficacy; Social support; Substance abuse problem; Techniques; Technology; Telephone; Testing; Text; Time; Treatment Protocols; Treatment outcome; alcohol abuse therapy; alcohol relapse; alcohol use disorder; base; computerized data processing; cost effective; cost effectiveness; craving; disorder later incidence prevention; experience; follow-up; health care service utilization; improved; innovation; intervention effect; medication compliance; method development; prevent; primary outcome; programs; psychologic; psychosocial; public health relevance; reduced alcohol use; response; skills; social; therapy development; transmission process; treatment adherence; treatment strategy; trend; user-friendly

DESCRIPTION (provided by applicant): The objective of the current research is to improve treatment for alcohol dependent adults by augmenting naltrexone pharmacotherapy with an innovative text-messaging strategy to promote relapse prevention skills, reduce HIV-risk behaviors, and improve naltrexone and HIV treatment regimen adherence. This application is in response to PA-10-013, "Behavioral & Integrative Treatment Development Program," which encourages "Studies on evidence-based treatment interventions that utilize various technologies in order to increase efficacy and/or increase community-friendliness; Research on behavioral treatments that complement and/or potentiate the effects of medications; Research on treatment interventions for...medical conditions that are co- occurring with substance abuse; and research on the development of methods and technologies relevant to treatment, adherence, and HIV prevention within the context of drug abuse treatment." Consistent with these stated objectives of the PA, the specific aims of this research are 1) To develop and refine, with user feedback, a cognitive behavioral therapy-based text-messaging intervention (TXT-CBT) to augment pharmacotherapy for alcohol dependence in HIV-infected adults with alcohol use disorders; 2) To conduct a pilot randomized clinical trial to assess the feasibility of recruiting and retaining individuals for a large scale study and to determine the effect size of TXT-CBT over and above medication management with naltrexone (MM) on alcohol use, HIV medication adherence, naltrexone adherence, and healthcare outcomes. Both MM and MM+TXT-CBT participants will be assessed at baseline, treatment-end, and 12 weeks post-treatment; and 3) To examine potential mechanisms of action of TXT-CBT, including self-efficacy, coping skills, and social support. We hypothesize that TXT-CBT delivered in conjunction with MM will produce greater reductions in alcohol use and HIV-risk behaviors, and will improve naltrexone and HIV treatment regimen adherence, relative to MM alone. Further, we expect that MM+TXT-CBT will facilitate greater changes in, self-efficacy, coping skills, and social support, and these changes will be associated with substance use outcomes. Preliminary data concerning cost-effectiveness will be gathered to begin to evaluate the cost savings associated with this technology-based intervention. TXT-CBT incorporates specific substance- and adherence-focused cognitive therapy techniques with a concurrent emphasis on reducing HIV-risk behaviors. By providing support to maximize HIV treatment regimen adherence, coupled with coping skills to prevent alcohol relapse, TXT-CBT may provide a promising, cost-effective, and easily deployable augmenting strategy for the treatment of alcohol users who are HIV- infected.

描述（由申请人提供）：当前研究的目的是通过创新的短信策略增强纳曲酮药物治疗，以提高复发预防技能、减少艾滋病毒危险行为并改善纳曲酮和艾滋病毒治疗，从而改善对酒精依赖成人的治疗坚持治疗方案。此申请是为了响应 PA-10-013“行为和综合治疗开发计划”，该计划鼓励“研究利用各种技术以提高疗效和/或增加社区友好性的循证治疗干预措施；研究补充和/或增强药物作用的行为治疗；针对与药物滥用同时发生的医疗状况的治疗干预研究，以及与治疗、依从性和艾滋病毒预防相关的方法和技术的开发研究；之内药物滥用治疗的背景。”与 PA 的这些既定目标一致，本研究的具体目标是 1) 根据用户反馈开发和完善基于认知行为疗法的短信干预 (TXT-CBT)，以增强 HIV 酒精依赖的药物治疗-患有酒精使用障碍的受感染成年人； 2) 进行随机临床试验以评估其可行性 招募和保留个体进行大规模研究，并确定 TXT-CBT 超过纳曲酮 (MM) 药物管理对饮酒、艾滋病毒药物依从性、纳曲酮依从性和医疗保健结果的影响大小。 MM 和 MM+TXT-CBT 参与者都将在基线、治疗结束和治疗后 12 周时接受评估； 3) 研究 TXT-CBT 的潜在作用机制，包括自我效能、应对技巧和社会支持。我们假设，与单独使用 MM 相比，TXT-CBT 与 MM 联合使用将更大程度地减少饮酒和 HIV 危险行为，并提高纳曲酮和 HIV 治疗方案的依从性。此外，我们预计 MM+TXT-CBT 将促进自我效能、应对技能和社会支持方面的更大变化，并且这些变化将与物质使用结果相关。将收集有关成本效益的初步数据，以开始评估与这种基于技术的干预措施相关的成本节约。 TXT-CBT 结合了特定的物质和依从性认知治疗技术，同时强调减少艾滋病毒危险行为。通过提供支持以最大限度地提高 HIV 治疗方案的依从性，再加上应对技巧以防止酒精复发，TXT-CBT 可以为感染 HIV 的酗酒者的治疗提供一种有前景、具有成本效益且易于部署的增强策略。