Supporting Treatment Adherence Readiness Through Training (START) for Patients with HIV on Antiretroviral Therapy

Study Protocol for a Randomized Controlled Trial

Published in: Trials, 2016

Posted on RAND.org on April 22, 2016

by Glenn Wagner, Sebastian Linnemayr, Bonnie Ghosh-Dastidar, Judith S. Currier, Risa Hoffman, Stefan Schneider

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Research Question

  1. Can an intervention that targets HIV patients before they begin treatment increase their adherence to treatment?

Few HIV antiretroviral adherence interventions target patients before they start treatment, assess adherence readiness to determine the timing of treatment initiation, or tailor the amount of adherence support. The Supporting Treatment Adherence Readiness through Training (START) intervention, based on the information-motivation-behavioral skills model of behavior change, is designed to address these gaps with the inclusion of (1) brief pill-taking practice trials for enhancing pretreatment adherence counseling and providing a behavioral criterion for determining adherence readiness and the timing of treatment initiation and (2) a performance-driven dose regulation mechanism to tailor the amount of counseling to the individual needs of the patient and conserve resources. The primary aim of this randomized controlled trial is to examine the effects of START on antiretroviral adherence and HIV virologic suppression.

Key Findings

  • A brief pill-taking practice may provide a behavioral benchmark for adherence.
  • A performance-driven dose regulation mechanism may tailor counseling to the individual needs of the patient.
  • If the intervention is shown to be efficacious and cost effective, it could give clinicians a new model for assessing patients' readiness to adhere to treatment and could help patients achieve optimal health benefits.

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