Assessing Differential Adherence to Medications and Quality of Life Among People Living With HIV and Comorbidities
| Status: | Recruiting |
|---|---|
| Conditions: | HIV / AIDS |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 8/30/2018 |
| Start Date: | December 12, 2017 |
| End Date: | July 2019 |
| Contact: | Frances R Wallach, MD |
| Email: | fwallach@northwell.edu |
| Phone: | 516-562-4280 |
The investigators propose to utilize quantitative and qualitative methodology to better
understand the impact of multiple drug use (polypharmacy) on medication adherence as well as
the driving forces behind differential adherence in people living with HIV (PLWH) with
comorbidities. Since the clinical relevance of differential adherence to antiretroviral
therapy (ART) medication has already been demonstrated and associated with virologic failure
and a more rapid progression to AIDS and death, it is imperative to understand the driving
forces behind differential adherence (selective drug taking) and its impact on treatment
outcomes in PLWH with comorbidities. Moreover, the use of technology to improve medication
adherence is receiving much attention, and there are several smartphone applications that
send medication reminders and generate personalized text messages to further motivate users.
This type of technology could be particularly beneficial to patients who are managing
multiple medications for multiple conditions. To this end, the investigators propose to use
the medication adherence smartphone-based application, 'Technology for Engagement And
Management of Health (TEAMH) to track both medication adherence and medication side effects
in real-time among PLWH with comorbidities. TEAMH is an interactive health care information
technology system that is not only patient-centered in that it encourages patient engagement
in health care self-management, but also offers significant cost savings by directly
connecting patients with their health care providers allowing providers to quickly address
any health issue that may arise, thus potentially avoiding costly hospitalizations later on.
understand the impact of multiple drug use (polypharmacy) on medication adherence as well as
the driving forces behind differential adherence in people living with HIV (PLWH) with
comorbidities. Since the clinical relevance of differential adherence to antiretroviral
therapy (ART) medication has already been demonstrated and associated with virologic failure
and a more rapid progression to AIDS and death, it is imperative to understand the driving
forces behind differential adherence (selective drug taking) and its impact on treatment
outcomes in PLWH with comorbidities. Moreover, the use of technology to improve medication
adherence is receiving much attention, and there are several smartphone applications that
send medication reminders and generate personalized text messages to further motivate users.
This type of technology could be particularly beneficial to patients who are managing
multiple medications for multiple conditions. To this end, the investigators propose to use
the medication adherence smartphone-based application, 'Technology for Engagement And
Management of Health (TEAMH) to track both medication adherence and medication side effects
in real-time among PLWH with comorbidities. TEAMH is an interactive health care information
technology system that is not only patient-centered in that it encourages patient engagement
in health care self-management, but also offers significant cost savings by directly
connecting patients with their health care providers allowing providers to quickly address
any health issue that may arise, thus potentially avoiding costly hospitalizations later on.
TEAMH technology provides: 1) calendar-based medication reminders; 2) specific medication
information tailored to each patient's medication regimen; 3) health education material; 4)
direct contact with a health care provider through text messaging to discuss patients'
symptoms and side effects and; 5) reminders for medical appointments as well as medication
refills and laboratory testing. TEAMH provides a constant dialog between provider and patient
through ongoing text messaging, allowing providers to regularly monitor patients' adherence
to their medication regimen (data is transmitted directly to the providers) and to their
medical appointments. Any number of medications can be included, making it ideal for HIV
patients with comorbidities. In addition, TEAMH has the potential to interface with the
Northwell Health (NH) electronic medical record (EMR) system allowing for the collection of
comprehensive health information on each patient (e.g., lab results, medical appointments,
hospitalizations) participating in the study.
information tailored to each patient's medication regimen; 3) health education material; 4)
direct contact with a health care provider through text messaging to discuss patients'
symptoms and side effects and; 5) reminders for medical appointments as well as medication
refills and laboratory testing. TEAMH provides a constant dialog between provider and patient
through ongoing text messaging, allowing providers to regularly monitor patients' adherence
to their medication regimen (data is transmitted directly to the providers) and to their
medical appointments. Any number of medications can be included, making it ideal for HIV
patients with comorbidities. In addition, TEAMH has the potential to interface with the
Northwell Health (NH) electronic medical record (EMR) system allowing for the collection of
comprehensive health information on each patient (e.g., lab results, medical appointments,
hospitalizations) participating in the study.
Inclusion Criteria
All patients must:
- be HIV infected
- be English speaking
- be 18 years or older
- have at least one comorbidity requiring, at least, one additional chronic medication
(defined as a medication that the person needs to be taking for at least six months).
Exclusion Criteria
- Evidence of cognitive impairment that limits the ability to complete the intervention
- Terminally ill patients will be also excluded.
We found this trial at
1
site
350 Community Drive
Manhasset, New York 11030
Manhasset, New York 11030
Phone: 516-562-3361
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