Abstract
Session presented on: Thursday, July 25, 2013:
Purpose: To test the effectiveness of a culturally adapted evidence-based home nursing intervention to improve adherence to antiretroviral medications among people living with HIV/AIDS (PLWH/A) in Hunan, China.
Methods: In a randomized, controlled trial, 114 subjects were assigned to receive a culturally adapted intervention consisting of monthly visits and interim phone calls plus standard care or standard care alone. The intervention previously demonstrated efficacy in a randomized clinical trial conducted in the United States. All subjects were residents of Hunan, China, living with HIV/AIDS and self-reporting less than 90% adherence to prescribed medications. Measures included a 7-day visual analogue medication adherence scale, a social support rating scale, the Chinese version of the Center for Epidemiological Studies Depression scale Chinese, and an HIV/AIDS stigma scale. Data were collected in structured face-to-face interviews at baseline, 6 months, and 12 months at the time of a regularly scheduled clinical visit. Information regarding ARV regimen, treatment duration, time of diagnosis, CD4 count and HIV-RNA was extracted from the medical record.
Results: Subjects were 72% male (N=82); 52% (N=59) married; and only 28% (N=32) stably employed. Thirty-one percent (N=35) reported past or current drug abuse. The great majority (98%) had a CD4 count at baseline that was less than 350 cells/mm3. At 6 months and 12 months, a greater proportion of subjects in the intervention group self-reported adherence greater than 90% compared to the control group. The difference over time is significant (Extended Mantel-Haenszel Test: 8.8, p=.003).
Conclusions: In spite of significant cultural differences, evidence-based interventions can be implemented effectively in new settings and with new populations.
Sigma Membership
Unknown
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Home Nursing Intervention, HIV/AIDS, Medication Adherence
Recommended Citation
Williams, Ann Bartley; Fennie, Kristopher P.; Li, Xian Hong; Burgess, Jane; and Wang, Hong Hong, "Adapting and testing an evidence-based antiretroviral medication adherence intervention in China" (2013). INRC (Congress). 240.
https://www.sigmarepository.org/inrc/2013/presentations_2013/240
Conference Name
24th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Prague, Czech Republic
Conference Year
2013
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Adapting and testing an evidence-based antiretroviral medication adherence intervention in China
Prague, Czech Republic
Session presented on: Thursday, July 25, 2013:
Purpose: To test the effectiveness of a culturally adapted evidence-based home nursing intervention to improve adherence to antiretroviral medications among people living with HIV/AIDS (PLWH/A) in Hunan, China.
Methods: In a randomized, controlled trial, 114 subjects were assigned to receive a culturally adapted intervention consisting of monthly visits and interim phone calls plus standard care or standard care alone. The intervention previously demonstrated efficacy in a randomized clinical trial conducted in the United States. All subjects were residents of Hunan, China, living with HIV/AIDS and self-reporting less than 90% adherence to prescribed medications. Measures included a 7-day visual analogue medication adherence scale, a social support rating scale, the Chinese version of the Center for Epidemiological Studies Depression scale Chinese, and an HIV/AIDS stigma scale. Data were collected in structured face-to-face interviews at baseline, 6 months, and 12 months at the time of a regularly scheduled clinical visit. Information regarding ARV regimen, treatment duration, time of diagnosis, CD4 count and HIV-RNA was extracted from the medical record.
Results: Subjects were 72% male (N=82); 52% (N=59) married; and only 28% (N=32) stably employed. Thirty-one percent (N=35) reported past or current drug abuse. The great majority (98%) had a CD4 count at baseline that was less than 350 cells/mm3. At 6 months and 12 months, a greater proportion of subjects in the intervention group self-reported adherence greater than 90% compared to the control group. The difference over time is significant (Extended Mantel-Haenszel Test: 8.8, p=.003).
Conclusions: In spite of significant cultural differences, evidence-based interventions can be implemented effectively in new settings and with new populations.