Acquired Immunodeficiency Syndrome (AIDS) Clinical Trial
Official title:
The Living Well Project: Early Palliative Care and Motivational Interviewing (MI) for Persons With AIDS
The overall goal of this project is to implement and test the efficacy of an enhanced comprehensive multidisciplinary early palliative care (EPC) package that includes four motivational interviewing sessions (MI) for persons diagnosed with AIDS. We posit that the innovative EPC will improve quality of life, clinical and psychosocial outcomes and advance care planning in a cost effective manner and could promote engagement and retention in HIV care. If successful, it could serve as a model of early palliative care for persons with AIDS in the US.
The overall goal of this project is to improve the health and quality of life of persons
living with HIV/AIDS (PLWH). To this end, we will implement an innovative model of enhanced
early integrative palliative care services (EPC) for persons diagnosed with AIDS. Patients
will be recruited from either the inpatient service or outpatient infectious disease program
(IDP) at the Grady Health System (GHS) in Atlanta, Georgia. The AIDS EPC Package includes use
of motivational interviewing (MI) to facilitate adjustment to disease and advance care
planning decision making. The project has three specific aims:
Aim 1. Conduct a research clinical trial (RCT) to examine the efficacy of the AIDS EPC
Package intervention vs. standard HIV care (SOC) and compare outcomes at 12 months post
baseline. Our hypothesis is that those in the AIDS EPC group will have:
i. Better clinical outcomes: a lower one year mortality, higher proportion who initiate
antiretroviral therapy (ART), higher proportion with virologic suppression, higher CD4 gain,
fewer opportunistic infections (OI), fewer hospitalizations, lower depression scores, and
better symptom management (including cognitive dysfunction).
ii. Better psychosocial outcomes: Better coping skills, higher perceived social support,
higher spirituality, higher levels of self-advocacy, lower proportion who report substance
use.
iii. Better Quality of Life (QOL) and a higher proportion who report advance care planning
activities: named a surrogate; set personal goals regarding life saving measures; and
discussed these goals with a surrogate.
SECONDARY OUTCOMES:
Aim 2. Evaluate the cost effectiveness and cost utility of the AIDS EPC Package compared to
SOC where the outcomes are valued as survival and quality-adjusted life years (QALYs)
respectively.
Aim 3. Promote engagement and retention in HIV care as evidenced by attending a greater
proportion of scheduled appointments and reporting higher satisfaction with care compared to
SOC.
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Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT01849393 -
Evaluating Rewards-Based Adherence and Electronic Medication Monitoring in HIV-Positive Adolescents
|
N/A |