OBJECTIVE: To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (CBT-AD) in individuals with HIV. DESIGN: A two arm, randomized, controlled, cross-over trial comparing CBT-AD to enhanced treatment as usual only (ETAU). ETAU, which both groups received, included a single-session intervention for adherence and a letter to the patient's provider documenting her or his continued depression. The intervention group also received 10 to 12 sessions of CBT-AD. MAIN OUTCOME MEASURES: Adherence to antiretroviral therapy as assessed by Medication Event Monitoring Systems (MEMs) and depression as assessed by blinded structured evaluation. RESULTS: At the acute outcome assessment (3-months), those who received CBT-AD evidenced significantly greater improvements in medication adherence and depression relative to the comparison group. Those who were originally assigned to the comparison group who chose to cross over to CBT-AD showed similar improvements in both depression and adherence outcomes. Treatment gains for those in the intervention group were generally maintained at 6- and 12-month follow-up assessments. By the end of the follow-up period, those originally assigned CBT-AD demonstrated improvements in plasma HIV RNA concentrations, though these differences did not emerge before the cross-over, and hence there were not between-groups differences. CONCLUSIONS:CBT-AD is a potentially efficacious approach for individuals with HIV struggling with depression and adherence. Replication and extension in larger efficacy trials are needed. (c) 2009 APA, all rights reserved.
RCT Entities:
OBJECTIVE: To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (CBT-AD) in individuals with HIV. DESIGN: A two arm, randomized, controlled, cross-over trial comparing CBT-AD to enhanced treatment as usual only (ETAU). ETAU, which both groups received, included a single-session intervention for adherence and a letter to the patient's provider documenting her or his continued depression. The intervention group also received 10 to 12 sessions of CBT-AD. MAIN OUTCOME MEASURES: Adherence to antiretroviral therapy as assessed by Medication Event Monitoring Systems (MEMs) and depression as assessed by blinded structured evaluation. RESULTS: At the acute outcome assessment (3-months), those who received CBT-AD evidenced significantly greater improvements in medication adherence and depression relative to the comparison group. Those who were originally assigned to the comparison group who chose to cross over to CBT-AD showed similar improvements in both depression and adherence outcomes. Treatment gains for those in the intervention group were generally maintained at 6- and 12-month follow-up assessments. By the end of the follow-up period, those originally assigned CBT-AD demonstrated improvements in plasma HIV RNA concentrations, though these differences did not emerge before the cross-over, and hence there were not between-groups differences. CONCLUSIONS:CBT-AD is a potentially efficacious approach for individuals with HIV struggling with depression and adherence. Replication and extension in larger efficacy trials are needed. (c) 2009 APA, all rights reserved.
Authors: J Leserman; E D Jackson; J M Petitto; R N Golden; S G Silva; D O Perkins; J Cai; J D Folds; D L Evans Journal: Psychosom Med Date: 1999 May-Jun Impact factor: 4.312
Authors: Scott M Hammer; Michael S Saag; Mauro Schechter; Julio S G Montaner; Robert T Schooley; Donna M Jacobsen; Melanie A Thompson; Charles C J Carpenter; Margaret A Fischl; Brian G Gazzard; Jose M Gatell; Martin S Hirsch; David A Katzenstein; Douglas D Richman; Stefano Vella; Patrick G Yeni; Paul A Volberding Journal: JAMA Date: 2006-08-16 Impact factor: 56.272
Authors: Jane M Simoni; Steven A Safren; Lisa E Manhart; Karen Lyda; Cynthia I Grossman; Deepa Rao; Matthew J Mimiaga; Frank Y Wong; Sheryl L Catz; Michael B Blank; Ralph DiClemente; Ira B Wilson Journal: AIDS Behav Date: 2011-02
Authors: Alexander C Tsai; Dan H Karasic; Gwendolyn P Hammer; Edwin D Charlebois; Kathy Ragland; Andrew R Moss; James L Sorensen; James W Dilley; David R Bangsberg Journal: Am J Public Health Date: 2012-06-21 Impact factor: 9.308
Authors: Michael B Blank; Seth S Himelhoch; Alexandra B Balaji; David S Metzger; Lisa B Dixon; Charles E Rose; Emeka Oraka; Annet Davis-Vogel; William W Thompson; James D Heffelfinger Journal: Am J Public Health Date: 2014-02-13 Impact factor: 9.308
Authors: Mahnaz R Charania; Khiya J Marshall; Cynthia M Lyles; Nicole Crepaz; Linda S Kay; Linda J Koenig; Paul J Weidle; David W Purcell Journal: AIDS Behav Date: 2014-04
Authors: Jonathan M Feldman; Lynne Matte; Alejandro Interian; Paul M Lehrer; Shou-En Lu; Bari Scheckner; Dara M Steinberg; Tanya Oken; Anu Kotay; Sumita Sinha; Chang Shim Journal: Behav Res Ther Date: 2016-09-17