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基于计算机的干预措施在 HIV 临床护理环境中提高了抗逆转录病毒的依从性:LifeWindows 项目。

Computer-based intervention in HIV clinical care setting improves antiretroviral adherence: the LifeWindows Project.

机构信息

Department of Psychology, University of Connecticut, Storrs, USA.

出版信息

AIDS Behav. 2011 Nov;15(8):1635-46. doi: 10.1007/s10461-011-9926-x.

Abstract

We evaluated the efficacy of LifeWindows, a theory-based, computer-administered antiretroviral (ARV) therapy adherence support intervention, delivered to HIV + patients at routine clinical care visits. 594 HIV + adults receiving HIV care at five clinics were randomized to intervention or control arms. Intervention vs. control impact in the intent-to-treat sample (including participants whose ARVs had been entirely discontinued, who infrequently attended care, or infrequently used LifeWindows) did not reach significance. Intervention impact in the On Protocol sample (328 intervention and control arm participants whose ARVs were not discontinued, who attended care and were exposed to LifeWindows regularly) was significant. On Protocol intervention vs. control participants achieved significantly higher levels of perfect 3-day ACTG-assessed adherence over time, with sensitivity analyses maintaining this effect down to 70% adherence. This study supports the utility of LifeWindows and illustrates that patients on ARVs who persist in care at clinical care sites can benefit from adherence promotion software.

摘要

我们评估了 LifeWindows 的疗效,这是一种基于理论的、计算机管理的抗逆转录病毒 (ARV) 治疗依从性支持干预措施,在常规临床护理就诊时提供给 HIV + 患者。594 名在五家诊所接受 HIV 护理的 HIV + 成年人被随机分配到干预组或对照组。意向治疗样本(包括那些已完全停止服用 ARV 的参与者、很少参加护理的参与者或很少使用 LifeWindows 的参与者)中,干预与对照组的影响没有达到显著水平。在按方案样本(328 名干预组和对照组参与者,他们的 ARV 未停止,定期参加护理并接触 LifeWindows)中,干预的影响是显著的。按方案的干预组与对照组参与者在完美的 3 天 ACTG 评估的依从性方面随着时间的推移显著提高,敏感性分析显示,这种效果一直持续到 70%的依从性。这项研究支持 LifeWindows 的实用性,并表明在临床护理点坚持护理的服用 ARV 的患者可以从依从性促进软件中受益。

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