HIV Infection Primary Clinical Trial
Assessing Differential Adherence to Medications and Quality of Life Among People Living With HIV and Comorbidities
|Contact||Paola DiMarzio, Ph.D|
|Start date||December 12, 2017|
|Completion date||July 2019|
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.
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.