AIDS and Behavior

, 15:1635 | Cite as

Computer-Based Intervention in HIV Clinical Care Setting Improves Antiretroviral Adherence: The LifeWindows Project

  • Jeffrey D. Fisher
  • K. Rivet Amico
  • William A. Fisher
  • Deborah H. Cornman
  • Paul A. Shuper
  • Cynthia Trayling
  • Caroline Redding
  • William Barta
  • Anthony F. Lemieux
  • Frederick L. Altice
  • Kevin Dieckhaus
  • Gerald Friedland
  • for the LifeWindows Team
Original Paper

Abstract

We evaluated the efficacy of LifeWindows, a theory-based, computer-administered antiretroviral (ARV) therapy adherence support intervention, delivered to HIV + patients at routine clinical care visits. 594 HIV + adults receiving HIV care at five clinics were randomized to intervention or control arms. Intervention vs. control impact in the intent-to-treat sample (including participants whose ARVs had been entirely discontinued, who infrequently attended care, or infrequently used LifeWindows) did not reach significance. Intervention impact in the On Protocol sample (328 intervention and control arm participants whose ARVs were not discontinued, who attended care and were exposed to LifeWindows regularly) was significant. On Protocol intervention vs. control participants achieved significantly higher levels of perfect 3-day ACTG-assessed adherence over time, with sensitivity analyses maintaining this effect down to 70% adherence. This study supports the utility of LifeWindows and illustrates that patients on ARVs who persist in care at clinical care sites can benefit from adherence promotion software.

Keywords

ARV Adherence Intervention IMB-model ART 

Resumen

Evaluamos la eficacia de LifeWindows, una intervención de apoyo para la adherencia a la terapia antirretroviral (TAR) basada en teoría y con administración informatizada para pacientes con VIH + en sus visitas clínicas rutinarias. 594 adultos de cinco clínicas con VIH + y bajo tratamiento fueron aleatoriamente asignados a un grupo de intervención o de control. No se alcanzó significación estadística al comparar ambos grupos bajo la estrategia de ‘intención de tratar’ (incluyendo los participantes cuyos TAR se habían interrumpido por completo, habían asistido a la clínica en pocas ocasiones, o usaron LifeWindows con poca frecuencia). Sin embargo, la intervención obtuvo un impacto significativo cuando se evaluó con la muestra bajo Protocolo (un total de 328 participantes cuyos TAR no fueron interrumpidos, asistieron a sus visitas clínicas y se expusieron a LifeWindows regularmente). Los participantes bajo Protocolo de intervención obtuvieron niveles más altos de adherencia que el grupo control en tres días de Estudios de Grupos Clinicos con SIDA (EGCS) con repetidas evaluaciones y manteniendo como mínimo un 70% de la adherencia. Este estudio apoya la utilidad de LifeWindows e indica que los pacientes con TAR que asisten a las visitas clínicas, pueden beneficiarse de este software de promoción de la adherencia.

Keywords

AR Adherencia Intervención IMB-modelo TAR 

Notes

Acknowledgment

This study was funded by a National Institute of Mental Health grant (5 R01 MH066684), Jeffrey D. Fisher, Principal Investigator.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jeffrey D. Fisher
    • 1
    • 2
  • K. Rivet Amico
    • 2
  • William A. Fisher
    • 3
  • Deborah H. Cornman
    • 2
  • Paul A. Shuper
    • 4
    • 5
  • Cynthia Trayling
    • 4
  • Caroline Redding
    • 2
  • William Barta
    • 2
  • Anthony F. Lemieux
    • 6
  • Frederick L. Altice
    • 7
  • Kevin Dieckhaus
    • 8
  • Gerald Friedland
    • 7
  • for the LifeWindows Team
  1. 1.Department of PsychologyUniversity of ConnecticutStorrsUSA
  2. 2.Center for Health, Intervention, and Prevention (CHIP)University of ConnecticutStorrsUSA
  3. 3.Departments of Psychology and Obstetrics and GynecologyUniversity of Western OntarioLondonCanada
  4. 4.Centre for Addiction and Mental HealthTorontoCanada
  5. 5.Department of PsychologyUniversity of TorontoTorontoCanada
  6. 6.School of Natural and Social Sciences, Purchase CollegeState University of New YorkPurchaseUSA
  7. 7.AIDS Program, Department of Internal MedicineYale University School of MedicineNew HavenUSA
  8. 8.University of Connecticut Health CenterFarmingtonUSA

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