This proposal responds to NIDA PA-94-078, """"""""Behavioral Therapies Development Program"""""""" for the development, refinement, and pilot efficacy testing of therapeutic interventions Drug abuse treatment programs increasingly provide care to patients with HIV disease. Patients are receiving more complicated HIV-related prescription medications; yet noncompliance to the medications is significant, resulting in exacerbated illness and medical costs. This Stage I behavioral therapies development project develops, refines, and pilot-tests a medication management intervention and develops measures to assess its efficacy and cost-effectiveness. The subjects will be HIV-positive opiate abusers in methadone maintenance. They will have been identified as having problems with adherence to AIDS medications. The project will refine the medication management through an iterative process of trial application and revision of the treatment manual. Two 10-patient cohorts of medication management will be conducted at a university-based methadone treatment program; following this the treatment manual and measures will be refined based on this experience; then the medication management treatment will be extended to a community-based methadone maintenance clinic, conducting two more patient cohorts. The project will develop measures of therapist fidelity and competence, medication adherence, costs of medication management, and health service utilization, as well as manualize the intervention. Outcome measures will include level of medication adherence, health status, illicit drug use, and risk behaviors that transmit HIV infection. The change in outcome measures achieved by subjects from the four-week baseline period to a four-week follow-up will estimate the effect size of the medication management intervention, in preparation for further research in a Stage II clinical trial.
| Barnett, Paul G; Sorensen, James L; Wong, Wynnie et al. (2009) Effect of incentives for medication adherence on health care use and costs in methadone patients with HIV. Drug Alcohol Depend 100:115-21 |
| Sorensen, James L; Haug, Nancy A; Delucchi, Kevin L et al. (2007) Voucher reinforcement improves medication adherence in HIV-positive methadone patients: a randomized trial. Drug Alcohol Depend 88:54-63 |
| Sorensen, James L; Masson, Carmen L; Perlman, David C (2002) HIV/hepatitis prevention in drug abuse treatment programs: guidance from research. Sci Pract Perspect 1:4-11 |
| Sorensen, J L; Mascovich, A; Wall, T L et al. (1998) Medication adherence strategies for drug abusers with HIV/AIDS. AIDS Care 10:297-312 |
