192545 A Videophone-Delivered Medication Adherence Intervention for Persons Living With HIV: A Case Study of a Rural Participant

Wednesday, November 11, 2009

Cameron Camp, PhD , Research, Hearthstone Alzheimer Care, Woburn, MA
Michael Skrajner, MA , Research, Hearthstone Alzheimer Care, Woburn, MA
Arlene Kochman, LCSW , Callen Lord Community Health Center, New York, NY
Timothy Heckman, PhD , Department of Geriatric Medicine, Ohio University, Athens, OH
Jessica Haberman, MA , Research and Development, Hearthstone Alzheimer Care, Wickliffe
Background: Consistent adherence to antiretroviral therapy (ART) is required for the suppression of HIV. However, maintaining adequate adherence is challenging for many persons living with HIV, particularly those living in rural areas. The goal of an ongoing NIMH-funded study is to test the feasibility and efficacy of a medication adherence intervention delivered via videophones to urban and rural persons living with HIV/AIDS. Methods: A case study of “George,” a 50-year-old, HIV-positive gay white man living in rural Ohio is presented in this abstract. Videophone-delivered pill counts conducted before the intervention revealed a baseline adherence rate of 73.5%. A social worker based in New York conducted eight videophone intervention sessions (most 15 minutes in length) with George. The intervention was based upon Nancy Reynolds' “HAART Care” program. Because George frequently forgot to take his pills with him when he left his house each morning, a primary goal involved enabling George to remember to place his pills by his wallet and keys every evening. Results: George's post-intervention adherence rates improved substantially compared to his pre-intervention level: 92.9% at one-week follow-up; 100% at one-month; 98.5% at two-month; and 80.1% at three-month. Conclusion: This case study suggests that videophones offer a feasible, efficacious, and potentially cost-effective means by which to improve and assess ART adherence. Booster sessions are now being used to help maintain initial results of the intervention. Videophone-based interventions might be particularly appropriate for HIV-infected rural persons, because they typically lack easy access to resources that can facilitate their ART adherence efforts.

Learning Objectives:
1. Describe the procedures used to conduct videophone-based pill counts. 2. Describe the key aspects of the medication adherence intervention used in this study. 3. Discuss a case study from the first phase of this study.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Jessica L. Haberman is a Research Associate at Hearthstone Research and Development. She has been working on federally-funded research projects for about three years. In one project, she has been training persons with dementia to lead group activities for persons with more advanaced dementia. She has also been working on a study in which HIV-positive individuals are receiving a medication adherence intervention via videophone. She has a Master's degree in Clinical Psychology, and is currently pursuing a PhD in Counseling Psychology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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