A Preliminary Randomized Controlled Trial of a Nurse-Delivered Medication Adherence Intervention Among HIV-Positive Outpatients Initiating Antiretroviral Therapy in Beijing,China |
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Authors: | Jane M Simoni Wei-Ti Chen David Huh Karen I Fredriksen-Goldsen Cynthia Pearson Hongxin Zhao Cheng-Shi Shiu Xin Wang Fujie Zhang |
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Institution: | (1) Department of Psychology, University of Washington, 3909 Stevens Way NE, Campus Box 351525, Seattle, WA 98195-1525, USA;(2) Department of Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA;(3) School of Social Work, University of Washington, Seattle, WA, USA;(4) Institute of Infectious Diseases, Capital Medical University, Ditan Hospital, Beijing, China;(5) School of Social Service Administration, University of Chicago, Chicago, IL, USA;(6) Division of Treatment and Care, National Center for AIDS/STD Control and Prevention, Beijing, China |
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Abstract: | We evaluated a nurse-delivered adherence intervention in a preliminary randomized controlled trial among 70 HIV-positive outpatients
initiating antiretroviral therapy (ART) in Beijing, China. In both arms, participants received a 30-min educational session,
a pillbox, and a referral to a peer support group. In the enhanced arm, participants could choose an electronic reminder device,
three sessions of counseling either alone or with a treatment adherence partner, or both reminder and counseling. Survey assessments
and blood draws occurred at baseline, post-intervention (13 weeks), and follow-up (25 weeks). Primary outcomes were 7-day
and 30-day adherence assessed by self-report and electronic drug monitoring (EDM), and secondary outcomes were HIV-1 RNA viral
load and CD4 count. The intervention was feasible and well received. It led to some improvement in self-reported and EDM-assessed
adherence but not the biological outcomes. Providing counseling and facilitating the use of electronic reminders to patients
initiating ART merits further investigation as a culturally viable means of promoting adherence in China. |
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