Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD)
| Autor: | Sarah L. Hale, Julie Schexnayder, Valerie Smith, Sarah Gonzales, Rajesh Vedanthan, Virginie Lopez-Kidwell, Charles Muiruri, Hayden B. Bosworth, Gerald S. Bloomfield, Megan M. Oakes, Emily W. Choi, Allison R. Webel, Corrilynn O. Hileman, Angela Aifah, Chris T. Longenecker, Nwora Lance Okeke |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
MEDLINE Psychological intervention Blood Pressure Hyperlipidemias 030204 cardiovascular system & hematology Article HIV Long-Term Survivors Medication Adherence 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Electronic Health Records Humans Multicenter Studies as Topic Medicine 030212 general & internal medicine Hiv treatment Intensive care medicine Practice Patterns Nurses' business.industry Blood Pressure Monitoring Ambulatory Atherosclerosis Cholesterol Blood pressure Cardiovascular Diseases Hypertension Ambulatory Disease prevention Cardiology and Cardiovascular Medicine business |
| Zdroj: | Am Heart J |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2019.07.005 |
| Popis: | Persons living with human immunodeficiency virus (PLHIV) are at increased risk of atherosclerotic cardiovascular disease (ASCVD). In spite of this, uptake of evidence-based clinical interventions for ASCVD risk reduction in the HIV clinic setting is sub-optimal. METHODS: EXTRA-CVD is a 12-month randomized clinical effectiveness trial that will assess the efficacy of a multi-component nurse-led intervention in reducing ASCVD risk among PLHIV. Three hundred high ASCVD risk PLHIV across three sites will be randomized 1:1 to usual care with generic prevention education or the study intervention. The study intervention will consist of four evidence-based components: (1) nurse-led care coordination, (2) nurse-managed medication protocols and adherence support (3) home BP monitoring, and (4) electronic health records support tools. The primary outcome will be change in systolic blood pressure and secondary outcome will be change in non-HDL cholesterol over the course of the intervention. Tertiary outcomes will include change in the proportion of participants in the following extended cascade categories: (1) appropriately diagnosed with hypertension and hyperlipidemia (2) appropriately managed; (3) at treatment goal (systolic blood pressure130 mm Hg and non-HDL cholesterolNational Lipid Association targets). CONCLUSIONS: The EXTRA-CVD trial will provide evidence appraising the potential impact of nurse-led interventions in reducing ASCVD risk among PLHIV, an essential extension of the HIV care continuum beyond HIV viral suppression. |
| Databáze: | OpenAIRE |
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