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一项考察电子干预措施促进艾滋病病毒药物依从性效果的试点研究。

Pilot study examining the efficacy of an electronic intervention to promote HIV medication adherence.

作者信息

Claborn Kasey R, Leffingwell Thad R, Miller Mary Beth, Meier Ellen, Stephens Johnny R

机构信息

a Department of Psychology , Oklahoma State University , Stillwater , OK , USA.

出版信息

AIDS Care. 2014;26(3):404-9. doi: 10.1080/09540121.2013.824534. Epub 2013 Aug 5.

Abstract

Widespread dissemination of current interventions designed to improve HIV medication adherence is limited by several barriers, including additional time and expense burdens on the health care systems. Electronic interventions could aid in dissemination of interventions in the clinic setting. This study developed and tested the feasibility and acceptability of a computer-based adaption of an empirically supported face-to-face adherence promotion intervention. HIV-positive individuals (N = 92) on antiretroviral therapy with self-reported adherence <95% were randomized to the electronic intervention + treatment as usual (TAU) or TAU only. Study outcome variables which included treatment self-efficacy and self-reported medication adherence were assessed at baseline and follow-up. Time × condition interaction effects in mixed model analysis of variance (ANOVAs) examined the differences in patterns of change in the outcome variables over time between the two groups. Participants in the electronic intervention condition reported higher levels of self-efficacy to adhere to their medication at follow-up compared to the control condition. Although nonsignificant, levels of adherence tended to improve over time in the intervention condition, while TAU adherence remained constant. This was the first study to investigate a single-session, computer-based adherence intervention. Results suggest that electronic interventions are feasible and this method may be effective at increasing self-efficacy and adherence among patients reporting suboptimal adherence levels.

摘要

旨在提高艾滋病毒药物依从性的当前干预措施的广泛传播受到多种障碍的限制,包括医疗保健系统额外的时间和费用负担。电子干预措施有助于在临床环境中传播干预措施。本研究开发并测试了一种基于计算机的、经实证支持的面对面依从性促进干预措施的改编版的可行性和可接受性。自我报告依从性<95%的接受抗逆转录病毒治疗的艾滋病毒阳性个体(N = 92)被随机分为电子干预+常规治疗(TAU)组或仅常规治疗组。在基线和随访时评估包括治疗自我效能感和自我报告的药物依从性在内的研究结果变量。在方差混合模型分析(ANOVA)中,时间×条件交互效应检验了两组之间结果变量随时间变化模式的差异。与对照组相比,电子干预组的参与者在随访时报告的坚持服药的自我效能感水平更高。虽然不显著,但干预组的依从性水平随时间有改善的趋势,而常规治疗组的依从性保持不变。这是第一项调查基于计算机的单节段依从性干预措施的研究。结果表明,电子干预措施是可行的,这种方法可能有效地提高报告依从性水平欠佳的患者的自我效能感和依从性。

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