Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT03799276 |
Other study ID # |
CREPATS 08 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
January 15, 2019 |
Est. completion date |
December 15, 2023 |
Study information
Verified date |
February 2024 |
Source |
Centre de Recherches et d'Etude sur la Pathologie Tropicale et le Sida |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Antiretroviral therapy is currently the only way to control HIV disease progression in HIV
infected subjects and to prevent transmission. However a sustained virological control
through antiretroviral therapy is requested for these objectives. There is currently 8-10% of
patients who failed therapy for many reasons other than virological resistance including
social unstability, psychiatric disorders, migrant status, drug or alcohol addictions.
Because many of these vulnerabilities can be managed and patients helped for following
adequately cares and treatments, study team designed the OPTICARE Program to help reduce
impact of the patients' vulnerabilities.
The OPTICARE study is designed as a prospective implementation interventional study which
aims to improve retention in care among vulnerable HIV infected patients over 48 weeks.
The OPTICARE program is a support program dedicated to patients either lost to follow up or
in highly fraility situation that will offer an individualized care management to fill their
gaps towards optimized care and control of viral replication. Our aim is, in patients virally
failing in relation with poor adherence to care and treatment to test first part whether
tracking proactively lost to follow up patients or detecting frail individuals at risk of
lost to care is effective and secondly to evaluate the efficacy, the feasibility and the
acceptability of an intervention tailored to each individual to get them to treatment success
with viral suppression. In our context, a randomized approach would not be seen as ethical or
possible in an environment where investigators need to evaluate such intervention as a pilot
approach. Investigators therefore enrolled patients in a cohort population study OPTICARE
program aim to actively identify vulnerable HIV+ population and promote optimal access to
health care to this population using retention in care program in order to enable long term
HIV infection control.
The primary objective is to assess the feasability and the effectiveness of the OPTICARE
program. The OPTICARE program aims to propose an individualized care to vulnerable HIV
infected patients (UNAIDS/Second 90% goal) and to drive them to treatment success
(UNAIDS/Third 90% goal) within a one-year period.
Description:
The OPTICARE program is an individualized program proposed to vulnerable HIV infected
patients according to a baseline evaluation of the clinical, social, psychological and
cultural aspects.
Once enrolled in the OPTICARE program, each patient will benefit of:
- A comprehensive and complete check up personal interview, through a daily visit, with a
physician, an educational nurse, a social worker and a cultural mediator (if needed), in
order to identify mains issues
- A specific follow up will be set up with obligatory visits at week 4, week 12, week 24,
week 36 and week 48 to assess the evolution of the previously identified issues. If
needed, additional visits will be set up.
- Regular (Day 15 and monthly) phone calls will be set up during the first six months of
the OPTICARE program.
- Each patient will be accompanied by a tutoring nurse who will be in direct contact with
the patient.
Regarding the specific needs, each patient may benefit of:
- a personal assistance to complete administrative procedures (update health insurance,
assistance to fill administrative papers, provide a budget for photo ID, transport
tickets)
- a personalized medical follow up with regular phone calls, home visits (if the patient
agrees), assistance in taking HIV medication (set up pillbox, therapeutic education)
- a close psychological and social support (connection with HIV organizations,
participation to monthly support group)
- a specific assistance related to dependence issues (connection with addiction
organization, sex therapist consultation)
A multidisciplinary team (physician, educational nurse, psychotherapist, social worker and
cultural mediator) will proactively assist the patient (home visits, recall) during a one
year follow up.
The program is initially proposed to the patient. In case of non-acceptance, the patient can
further join the program after 3 months.
Patients who do not accept the OPTICARE program will be followed up in standard of care
according to French HIV management guidelines.
(https://cns.sante.fr/actualites/prise-en-charge-du-vih-recommandations-du-groupe-dexperts/).
All administratives and social procedures will be given to the social district.