A Study of Two Adherence Plans to Help HIV-Positive Patients Take Their Medications Correctly

NCT ID: NCT00001129

Last Updated: 2013-10-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1248 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2003-06-30

Brief Summary

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The purpose of this study is to look at different ways to help patients follow their anti-HIV medication schedules.

It is very important that HIV-positive patients take their anti-HIV medications correctly so they get the best possible benefit from them. Taking the drugs correctly, called "adherence," may keep HIV virus levels in the blood (viral load) low for a longer time. However, anti-HIV medication schedules are often complicated, and many patients have difficulty remembering to take their drugs at the correct time. This study will look at 2 different ways to teach patients about the importance of taking their medications correctly and to remind them when to take their medications.

Detailed Description

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Adherence to antiretroviral (AR) therapy has become increasingly important in the management of HIV infection. Adherence to AR regimens is thought to be a critical factor in maintaining therapeutic drug levels, thus helping ensure viral suppression and minimizing the risk of drug resistance. However, AR regimens are often complex with demanding dosing schedules. Patients often miss doses because they simply forget; other factors such as substance abuse, depression, and low literacy levels also contribute to nonadherence. Adherence is influenced not only by individual behavior but also by the services, the quality of the patient-provider relationship, and the amount of social support offered the patient. There is no currently agreed upon, widely used, and generalizable intervention for improving adherence over the long course of HIV therapy. This study provides a long-term comparative evaluation of two interventions.

Clinical sites, rather than individual patients, are randomized to one of four groups: a medication manager, an electronic medication reminder system, a medication manager plus an electronic medication reminder system, or usual care. Special training sessions are held for the staff of participating units assigned to medication manager and/or electronic medication reminder system interventions. The medication manager is a research staff member who works individually with study patients, addressing the knowledge, motivation, and skills necessary for adherence. The electronic medication reminder system is ALR (A Little Reminder). This is a small, portable alarm that is programmed to sound and flash at the times of the patient's scheduled AR medication doses. Patients enrolling into either the FIRST or MDR-HIV study at clinical sites authorized to carry out this study are offered the option of participating in the adherence intervention to which the clinical site has been randomly assigned. Data collected through the FIRST and the MDR-HIV protocols are used to address the Adherence study objectives. Patients on the FIRST protocol are assessed for time to first plasma HIV-RNA level above 2,000 copies/ml. Also, patients on the FIRST and MDR-HIV studies are assessed for changes in viral load, resistance, CD4 cell counts, adherence, and other factors.

Conditions

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HIV Infections

Keywords

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Drug Therapy, Combination RNA, Viral Patient Compliance Anti-HIV Agents Viral Load Reminder Systems Treatment Experienced Treatment Naive

Study Design

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Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Interventions

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Electronic Medication Reminder System

Intervention Type DEVICE

Medication Manager

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Patients may be eligible for this study if they:

* Are enrolling in a qualifying CPCRA AR therapeutic study. Currently, the FIRST and MDR-HIV studies are the only qualifying protocols.

Exclusion Criteria

Patients will not be eligible for this study if they:

* Are enrolling at a clinic site that is unable to participate in this study for some reason.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sharon Mannheimer

Role: STUDY_CHAIR

Edward Morse

Role: STUDY_CHAIR

Locations

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Community Consortium / UCSF

San Francisco, California, United States

Site Status

Virginia Cafaro M.D.

San Francisco, California, United States

Site Status

Denver CPCRA / Denver Public Hlth

Denver, Colorado, United States

Site Status

Univ Hosp Infectious Diseases Clinic

Denver, Colorado, United States

Site Status

Yale Univ School of Medicine / AIDS Program

New Haven, Connecticut, United States

Site Status

Washington Reg AIDS Prog / Dept of Infect Dis

Washington D.C., District of Columbia, United States

Site Status

AIDS Research Consortium of Atlanta

Atlanta, Georgia, United States

Site Status

AIDS Research Alliance - Chicago

Chicago, Illinois, United States

Site Status

Louisiana Comm AIDS Rsch Prog / Tulane Univ Med

New Orleans, Louisiana, United States

Site Status

Wayne State Univ - WSU/DMC / Univ Hlth Ctr

Detroit, Michigan, United States

Site Status

Henry Ford Hosp

Detroit, Michigan, United States

Site Status

Southern New Jersey AIDS Clinical Trials

Camden, New Jersey, United States

Site Status

North Jersey Community Research Initiative

Newark, New Jersey, United States

Site Status

Partners in Research / New Mexico

Albuquerque, New Mexico, United States

Site Status

Harlem AIDS Treatment Grp / Harlem Hosp Ctr

New York, New York, United States

Site Status

Bronx-Lebanon Hosp Ctr

The Bronx, New York, United States

Site Status

The Research and Education Group

Portland, Oregon, United States

Site Status

Philadelphia FIGHT

Philadelphia, Pennsylvania, United States

Site Status

Univ TX Health Science Ctr

Houston, Texas, United States

Site Status

Richmond AIDS Consortium / Div of Infect Diseases

Richmond, Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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11617

Identifier Type: REGISTRY

Identifier Source: secondary_id

CPCRA 062

Identifier Type: -

Identifier Source: org_study_id