Testing a Nurse-Tailored HIV Medication Adherence Intervention

Holzemer, William L.; Bakken, Suzanne; Portillo, Carmen J.; Grimes, Richard M.; Welch, Jennifer Greene; Wantland, Dean; Mullan, Joseph T.

doi:10.1097/00006199-200605000-00005

Cited by 75 publications

(64 citation statements)

References 16 publications

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“…The current study suggests that a similar approach can be effective in a nonselected general clinic population of PLWH. This effectiveness study's results are also consistent with data from efficacy studies of cognitive-behavioral and motivational interviewing interventions (DiIorio et al, 2008;Golin et al, 2006;Holzemer et al, 2006;Koenig et al, 2008) and show that these research-based counseling techniques can be successfully applied in general care settings via telehealth delivery. Telephone delivery of adherence interventions may enhance fidelity to the underlying psychological counseling model by allowing RNs to focus exclusively on counseling as opposed to other aspects of care.…”

Section: Clinical and Research Implicationssupporting

confidence: 78%

“…Negative beliefs such as skepticism about the efficacy of ART, concerns about medication effects or adverse drug events (ADEs), and inaccurate ideas about using ART intermittently all predict nonadherence (Abel & Painter, 2003;Barfod et al, 2005;Deloria-Knoll et al, 2004). Cognitive-behavioral and educational models have shown some efficacy to address these problems (Holzemer et al, 2006;Koenig et al, 2008;Reynolds et al, 2008). Another technique with proven efficacy to promote ART adherence is motivational interviewing, which involves helping PLWH to clarify valued goals or objectives and then assisting them to see discrepancies between actual and desired behavior (DiIorio et al, 2008;Golin et al, 2006).…”

mentioning

confidence: 99%

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Telephone Nurse Counseling Improves HIV Medication Adherence: An Effectiveness Study

Cook¹,

McCabe²,

Emiliozzi³

et al. 2009

Journal of the Association of Nurses in AIDS Care

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Antiretroviral therapy remains a challenge for persons living with HIV (PLWH), who must maintain high levels of adherence to prevent viral resistance and treatment failure. This effectiveness study examined a telephonic nursing program to translate well-validated cognitive-behavioral and motivational interviewing adherence counseling into routine clinical care. Participants were 98 PLWH who were followed for up to 6 months after recruitment from HIV care settings across the United States. Each participant received telephone counseling (Mdn =three sessions) from a trained nurse who followed up with the participant over time. Nurses assessed participants' readiness for adherence, provided support to overcome identified barriers, and offered information based on participants' questions. At 6 months after the start of treatment, a greater percentage of participants had adherence at or above 95% than expected for this population, based on a clinical interview. Self-efficacy was related to baseline medication adherence, whereas other clinical and demographic variables were not. Attrition was a concern but was unrelated to adherence, self-efficacy, or clinical severity measures. Telephone counseling was associated with a relatively high percentage of participants reaching target antiretroviral therapy adherence levels and may be an effective method to disseminate psychologically based counseling into a broad range of care settings.

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Section: Clinical and Research Implicationssupporting

confidence: 78%

mentioning

confidence: 99%

Telephone Nurse Counseling Improves HIV Medication Adherence: An Effectiveness Study

Cook¹,

McCabe²,

Emiliozzi³

et al. 2009

Journal of the Association of Nurses in AIDS Care

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“…It is essential that nursing's general understanding of health literacy be explored. To date, nurse researchers have examined the prevalence of low health literacy in an urban primary care clinic (Artinian, Lange, Templin, Stallwood, & Hermann, 2002), knowledge of health literacy among students and health care providers (Jukkala et al, 2009), the readability of patient education materials (Wilson, 2009), the information needs of mothers over age 35 years (Carolan, 2007), predicting completion of advance directives (Campbell, Edwards, Ward, & Weatherby, 2007), HIV medication adherence (Holzemer et al, 2006), and the self-efficacy of parents=guardians of African American children with asthma within the context of health literacy (Wood, Price, Dake, Telljohann, & Khuder, 2010). However, thus far, no studies have been conducted to assess the knowledge of nursing professionals across educational preparation, role, or practice specialty, regarding nursing knowledge of health literacy, its impact on patient outcomes, or nursing use of resources to facilitate communication with individuals with low health literacy.…”

Section: Nursing and Health Literacymentioning

confidence: 99%

Knowledge and Perceptions of Health Literacy Among Nursing Professionals

Macabasco‐O'Connell

Fry-Bowers

2011

Journal of Health Communication

104

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Low health literacy affects nearly half of the U.S. population. Health care professionals may not recognize low health literacy in their patients nor understand its impact on health outcomes. The purpose of this pilot study was to describe nurses' knowledge and perceptions of low health literacy on patients, their practice, and the health system. This cross-sectional, descriptive study used a web-based survey to assess the knowledge and perceptions of health literacy among nursing professionals. Registered nurses licensed by the State of California were randomly selected and invited to participate in the study. Data analysis included descriptive statistics to describe nursing professionals' general knowledge and perceptions. Qualitative textual analysis was done on participant responses to a survey question that asks participants to define health literacy using their own words. Results of this study revealed that nursing professionals' knowledge of health literacy and their understanding on the role health literacy plays on patient health outcomes is limited. Health literacy was also reported to be a low priority among providers and organizations. Nursing plays an important role in direct patient care and in the delivery of health services. Educating nurses on health literacy and improving patient communication and understanding can improve health outcomes.

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“…Viral load differences were not statistically significant in their study. However, Holzemer and colleagues (19) found no significant effect of a nurse intervention on adherence, CD4 count, or viral load over a six-month period. Inconsistencies in intervention content and approach, differences in outcome time points, and the definition of adherence (80% versus 95%) in these and similar studies hinder the contextualization of our findings and reasonable comparison of effect sizes.…”

Section: Discussionmentioning

confidence: 96%

A Randomized Trial of a Nursing Intervention for HIV Disease Management Among Persons With Serious Mental Illness

Blank¹,

Hanrahan²,

Fishbein³

et al. 2011

Psychiatric Services

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Objective-The heightened risk of persons with serious mental illness to contract and transmit HIV is recognized as a public health problem. Persons with HIV and mental illness may be at risk for poor treatment adherence, development of treatment-resistant virus, and worse outcomes. The objective of this study was to test the effectiveness of a community-based advanced practice nurse (APN) intervention (PATH, Preventing AIDS Through Health) to promote adherence to HIV and psychiatric treatment regimens.Methods-Community-dwelling HIV-positive participants with co-occurring serious mental illnesses (N=238) were recruited from community HIV provider agencies from 2004 to 2008 to participate in the randomized controlled trial. Participants in the intervention group (N=128) were assigned an APN who provided community-based care management at a minimum of one visit per week and coordinated clients' medical and mental health care for one year. Viral load and CD4 cell count were evaluated at baseline and 12 months.Results-Longitudinal models for continuous log viral load showed that compared with the control group, the intervention group exhibited a significantly greater reduction in log viral load at 12 months (d=−.361 log 10 copies per milliliter, p<.001). Differences in CD4 counts from baseline to 12 months were not statistically significant. DisclosuresThe authors report no competing interests. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusions-This project demonstrated the effectiveness of community-based APNs in delivering a tailored intervention to improve outcomes of individuals with HIV and co-occurring serious mental illnesses. Persons with these co-occurring conditions can be successfully treated; with appropriate supportive services, their viral loads can be reduced.Persons with serious mental illnesses are at increased risk for contracting and transmitting HIV and have poor adherence to medication regimens. Estimates of the prevalence of HIV among persons with mental illnesses vary widely and range from 4% to 23%, compared to . 4%-.6% in the general population (1,2). Although already high, such estimates still may be underestimated and signal a hidden epidemic. A number of recent studies have drawn attention to the issue of undetected cases of HIV in inpatient psychiatric populations that are missed even by care providers (3,4).Early detection and treatment of HIV reduces the risk of its transmission and secondary infections, as well as treatment costs. Yet, the mentally ill population with HIV is one of the most difficult populations to treat because of cognitive dysfunction and poor adherence (5).Effective treatment of persons with HIV and comorbid mental illness is important from an individual clinical perspective as well as from a public health perspective. Persons with cooccurring HIV and mental illness are known to have higher rates of substance abuse and dependence as well as sexual risk behaviors (6). Finally, nonadherence to highly active ant...

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Testing a Nurse-Tailored HIV Medication Adherence Intervention

Cited by 75 publications

References 16 publications

Telephone Nurse Counseling Improves HIV Medication Adherence: An Effectiveness Study

Telephone Nurse Counseling Improves HIV Medication Adherence: An Effectiveness Study

Knowledge and Perceptions of Health Literacy Among Nursing Professionals

A Randomized Trial of a Nursing Intervention for HIV Disease Management Among Persons With Serious Mental Illness

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