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A mobile health intervention in HIV primary care: supporting patients at risk for ART non-adherence

机译:HIV 初级保健中的移动健康干预:支持有 ART 不依从风险的患者

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Mobile health (mHealth) interventions that are integrated in HIV clinical settings to facilitate ongoing patient-provider communication between primary care visits are garnering evidence for their potential in improving HIV outcomes. Rango is an mHealth intervention to support engagement in HIV care and treatment adherence. This study used a single-arm prospective design with baseline and 6-month assessments for pre-post comparisons, as well as a matched patient sample for between-group comparisons to test Rango's preliminary efficacy in increasing viral suppression. The Rango sample (n = 406) was predominantly 50 years of age or older (63; M = 50.67; SD = 10.97, 23-82), Black/African-American (44) or Hispanic/Latinx (38), and male (59). At baseline, 18 reported missing at least one dose of ART in the prior three days and chart reviews of recent VL showed that nearly 82 of participants were virally suppressed. Overall 95 of the patients enrolled in Rango returned for a medical follow-up visit. Of the 65 unsuppressed patients at baseline who returned for a medical visit, 38 (59) achieved viral suppression and only 5 of the suppressed group at baseline had an increase in viral load at 6 months despite being at risk for ART non-adherence. While viral suppression was similar between Rango participants and patients receiving treatment as usual over the same time period, it is unknown whether those patients were similarly at risk for non-adherence. Our findings support efforts to formally test this innovative approach in addressing ART non-adherence and viral suppression particularly to reach HIV treatment goals.
机译:在HIV临床环境中整合的移动医疗(mHealth)干预措施,以促进初级保健就诊之间的持续患者-提供者沟通,正在收集证据证明其在改善HIV结果方面的潜力。Rango 是一种移动医疗干预措施,旨在支持参与 HIV 护理和治疗依从性。本研究采用单臂前瞻性设计,对基线和 6 个月的评估进行前后比较,并使用匹配的患者样本进行组间比较,以测试 Rango 在增加病毒抑制方面的初步疗效。Rango 样本 (n = 406) 主要是 50 岁或以上 (63%;M = 50.67;SD = 10.97, 23-82)、黑人/非裔美国人 (44%) 或西班牙裔/拉丁裔 (38%) 和男性 (59%)。在基线时,18% 的人报告在过去三天内至少错过了一剂 ART,对近期 VL 的图表审查显示,近 82% 的参与者受到病毒抑制。总体而言,95% 的 Rango 患者返回进行医疗随访。在 65 例返回就诊的基线未抑制患者中,38 例 (59%) 实现了病毒抑制,基线时只有 5% 的抑制组在 6 个月时病毒载量增加,尽管存在 ART 不依从的风险。虽然在同一时期,Rango参与者和照常接受治疗的患者之间的病毒抑制相似,但尚不清楚这些患者是否同样面临不依从的风险。我们的研究结果支持正式测试这种创新方法在解决抗逆转录病毒治疗不依从性和病毒抑制方面的努力,特别是为了达到HIV治疗目标。

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