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    Protocol of a two arm randomised, multi-centre, 12-month controlled trial: Evaluating the impact of a Cognitive Behavioural Therapy (CBT)-based intervention Supporting UPtake and Adherence to antiretrovirals (SUPA) in adults with HIV

    Horne, R. and Glendinning, E. and King, K. and Chalder, T. and Sabin, C. and Walker, A.S. and Campbell, L.J. and Mosweu, I. and Anderson, J. and Collins, S. and Jopling, R. and McCrone, P. and Leake Date, H. and Michie, S. and Nelson, M. and Perry, N. and Smith, Jonathan A. and Sseruma, W. and Cooper, V. (2019) Protocol of a two arm randomised, multi-centre, 12-month controlled trial: Evaluating the impact of a Cognitive Behavioural Therapy (CBT)-based intervention Supporting UPtake and Adherence to antiretrovirals (SUPA) in adults with HIV. BMC Public Health (905), ISSN 1471-2458.

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    Abstract

    BACKGROUND: Delay to start antiretroviral therapy (ART) and nonadherence compromise the health and wellbeing of people living with HIV (PLWH), raise the cost of care and increase risk of transmission to sexual partners. To date, interventions to improve adherence to ART have had limited success, perhaps because they have failed to systematically elicit and address both perceptual and practical barriers to adherence. The primary aim of this study is to determine the efficacy of the Supporting UPtake and Adherence (SUPA) intervention. METHODS: This study comprises 2 phases. Phase 1 is an observational cohort study, in which PLWH who are ART naïve and recommended to take ART by their clinician complete a questionnaire assessing their beliefs about ART over 12 months. Phase 2 is a randomised controlled trial (RCT) nested within the observational cohort study to investigate the effectiveness of the SUPA intervention on adherence to ART. PLWH at risk of nonadherence (based on their beliefs about ART) will be recruited and randomised 1:1 to the intervention (SUPA intervention + usual care) and control (usual care) arms. The SUPA intervention involves 4 tailored treatment support sessions delivered by a Research Nurse utilising a collaborative Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI) approach. Sessions are tailored to individual needs and preferences based on the individual patient’s perceptions and practical barriers to ART. An animation series and intervention manual have been developed to communicate a rationale for the personal necessity for ART and illustrate concerns and potential solutions. The primary outcome is adherence to ART measured using Medication Event Monitoring System (MEMS). 372 patients will be sufficient to detect a 15% difference in adherence with 80% power and an alpha of 0.05. Costs will be compared between intervention and control groups. Costs will be combined with the primary outcome in cost-effectiveness analyses. Quality adjusted life-years (QALYs) will also be estimated over the follow-up period and used in the analyses. DISCUSSION: The findings will enable patients, healthcare providers and policy makers to make informed decisions about the value of the SUPA intervention.

    Metadata

    Item Type: Article
    School: Birkbeck Schools and Departments > School of Science > Psychological Sciences
    Depositing User: Jonathan A Smith
    Date Deposited: 23 Jul 2019 12:44
    Last Modified: 08 Dec 2019 22:48
    URI: http://eprints.bbk.ac.uk/id/eprint/28150

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