Menu
×
West Ashley Library
Closed
Phone: (843) 766-6635
Wando Mount Pleasant Library
Closed
Phone: (843) 805-6888
Village Library
Closed
Phone: (843) 884-9741
St. Paul's/Hollywood Library
Closed
Phone: (843) 889-3300
Otranto Road Library
Closed
Phone: (843) 572-4094
Mt. Pleasant Library
Closed
Phone: (843) 849-6161
McClellanville Library
Closed
Phone: (843) 887-3699
Keith Summey North Charleston Library
Closed
Phone: (843) 744-2489
John's Island Library
Closed
Phone: (843) 559-1945
Hurd/St. Andrews Library
Closed
Phone: (843) 766-2546
Folly Beach Library
Closed
Phone: (843) 588-2001
Miss Jane's Building (Edisto Library Temporary Location)
Closed
Phone: (843) 869-2355
Dorchester Road Library
Closed
Phone: (843) 552-6466
John L. Dart Library
Closed
Phone: (843) 722-7550
Baxter-Patrick James Island
Closed
Phone: (843) 795-6679
Main Library
2 p.m. – 5 p.m.
Phone: (843) 805-6930
Bees Ferry West Ashley Library
Closed
Phone: (843) 805-6892
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Mobile Library
Closed
Phone: (843) 805-6909
Today's Hours
West Ashley Library
Closed
Phone: (843) 766-6635
Wando Mount Pleasant Library
Closed
Phone: (843) 805-6888
Village Library
Closed
Phone: (843) 884-9741
St. Paul's/Hollywood Library
Closed
Phone: (843) 889-3300
Otranto Road Library
Closed
Phone: (843) 572-4094
Mt. Pleasant Library
Closed
Phone: (843) 849-6161
McClellanville Library
Closed
Phone: (843) 887-3699
Keith Summey North Charleston Library
Closed
Phone: (843) 744-2489
John's Island Library
Closed
Phone: (843) 559-1945
Hurd/St. Andrews Library
Closed
Phone: (843) 766-2546
Folly Beach Library
Closed
Phone: (843) 588-2001
Miss Jane's Building (Edisto Library Temporary Location)
Closed
Phone: (843) 869-2355
Dorchester Road Library
Closed
Phone: (843) 552-6466
John L. Dart Library
Closed
Phone: (843) 722-7550
Baxter-Patrick James Island
Closed
Phone: (843) 795-6679
Main Library
2 p.m. – 5 p.m.
Phone: (843) 805-6930
Bees Ferry West Ashley Library
Closed
Phone: (843) 805-6892
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Mobile Library
Closed
Phone: (843) 805-6909
Patron Login
menu
Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use: A Randomized Clinical Trial.
Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
- Author(s): Metsch, Lisa R.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Stitzer, Maxine; Das, Moupali; Jain, Mamta K.; Rodriguez, Allan E.; Armstrong, Wendy S.; Lucas, Gregory M.; Nijhawan, Ank E.; Drainoni, Mari-Lynn; Herrera, Patricia; Vergara-Rodriguez, Pamela; Jacobson, Jeffrey M.; Mugavero, Michael J.; Sullivan, Meg; Daar, Eric S.; McMahon, Deborah K.; Ferris, David C.
- Source:
JAMA: Journal of the American Medical Association. 7/12/2016, Vol. 316 Issue 2, p156-170. 15p. 1 Diagram, 4 Charts. - Source:
- Additional Information
- Subject Terms: HIV infection risk factors; HIV-positive persons; HOSPITAL patients; VIRAL load; MEDICAL case management; RANDOMIZED controlled trials; DISEASES; SUBSTANCE abuse; HIV infection complications; HIV infection epidemiology; COMPARATIVE studies; ECONOMICS; HIV; HIV infections; RESEARCH methodology; MEDICAL cooperation; MOTIVATION (Psychology); RESEARCH; RESEARCH funding; EVALUATION research; SOCIAL services case management; MOTIVATIONAL interviewing; TREATMENT effectiveness; PATIENT-centered care; ANTI-HIV agents; DISEASE complications
- Abstract:
Importance: Substance use is a major driver of the HIV epidemic and is associated with poor HIV care outcomes. Patient navigation (care coordination with case management) and the use of financial incentives for achieving predetermined outcomes are interventions increasingly promoted to engage patients in substance use disorders treatment and HIV care, but there is little evidence for their efficacy in improving HIV-1 viral suppression rates.Objective: To assess the effect of a structured patient navigation intervention with or without financial incentives to improve HIV-1 viral suppression rates among patients with elevated HIV-1 viral loads and substance use recruited as hospital inpatients.Design, Setting, and Participants: From July 2012 through January 2014, 801 patients with HIV infection and substance use from 11 hospitals across the United States were randomly assigned to receive patient navigation alone (n = 266), patient navigation plus financial incentives (n = 271), or treatment as usual (n = 264). HIV-1 plasma viral load was measured at baseline and at 6 and 12 months.Interventions: Patient navigation included up to 11 sessions of care coordination with case management and motivational interviewing techniques over 6 months. Financial incentives (up to $1160) were provided for achieving targeted behaviors aimed at reducing substance use, increasing engagement in HIV care, and improving HIV outcomes. Treatment as usual was the standard practice at each hospital for linking hospitalized patients to outpatient HIV care and substance use disorders treatment.Main Outcomes and Measures: The primary outcome was HIV viral suppression (≤200 copies/mL) relative to viral nonsuppression or death at the 12-month follow-up.Results: Of 801 patients randomized, 261 (32.6%) were women (mean [SD] age, 44.6 years [10.0 years]). There were no differences in rates of HIV viral suppression versus nonsuppression or death among the 3 groups at 12 months. Eighty-five of 249 patients (34.1%) in the usual-treatment group experienced treatment success compared with 89 of 249 patients (35.7%) in the navigation-only group for a treatment difference of 1.6% (95% CI, -6.8% to 10.0%; P = .80) and compared with 98 of 254 patients (38.6%) in the navigation-plus-incentives group for a treatment difference of 4.5% (95% CI -4.0% to 12.8%; P = .68). The treatment difference between the navigation-only and the navigation-plus-incentives group was -2.8% (95% CI, -11.3% to 5.6%; P = .68).Conclusions and Relevance: Among hospitalized patients with HIV infection and substance use, patient navigation with or without financial incentives did not have a beneficial effect on HIV viral suppression relative to nonsuppression or death at 12 months vs treatment as usual. These findings do not support these interventions in this setting.Trial Registration: clinicaltrials.gov Identifier: NCT01612169. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of JAMA: Journal of the American Medical Association is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Subject Terms:
Contact CCPL
Copyright 2022 Charleston County Public Library Powered By EBSCO Stacks 3.3.0 [350.3] | Staff Login
No Comments.