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Health Psychol. 2010 Jul;29(4):421-8. doi: 10.1037/a0020335.

Electronic monitoring-based counseling to enhance adherence among HIV-infected patients: a randomized controlled trial.

Author information

1
Department Work and Social Psychology, Maastricht University. Marijn, Amsterdam. debruin@wur.nl

Abstract

OBJECTIVE:

To investigated the effectiveness of an adherence intervention (AIMS) designed to fit HIV-clinics' routine care procedures.

DESIGN:

Through block randomization, patients were allocated to the intervention or control group. The study included 2 months baseline measurement, 3 months intervention, and 4 months follow-up. HIV-nurses delivered a minimal intervention ("adherence sustaining") to patients scoring >95% adherence at baseline, and an intensive intervention ("adherence improving") to patients with <95% adherence. Control participants received high-quality usual care.

MAIN OUTCOME MEASURES:

Electronically monitored adherence and viral load.

RESULTS:

133 patients were included (67 control, 66 intervention), 60% had <95% adherence at baseline, and 87% (116/133) completed the trial. Intent-to-treat analyses showed that adherence improved significantly in the complete intervention sample. Subgroup analyses showed that this effect was caused by participants scoring <95% at baseline (mean difference = 15.20%; p < .001). These effects remained stable during follow-up. The number of patients with an undetectable viral load increased in the intervention group compared to the control group (OR = 2.96, p < .05). Treatments effects on viral load were mediated by the improvements in adherence.

CONCLUSIONS:

The AIMS-intervention was effective and can be integrated in routine clinical care for HIV-infected patients. Future research should study its (cost)effectiveness among more heterogeneous samples and in settings with variable levels of standard care.

PMID:
20658830
DOI:
10.1037/a0020335
[Indexed for MEDLINE]

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