Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD).
Atherosclerosis
/ blood
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cardiovascular Diseases
/ blood
Cholesterol
/ blood
Electronic Health Records
HIV Long-Term Survivors
Humans
Hyperlipidemias
/ diagnosis
Hypertension
/ diagnosis
Medication Adherence
Multicenter Studies as Topic
Practice Patterns, Nurses'
/ organization & administration
Journal
American heart journal
ISSN: 1097-6744
Titre abrégé: Am Heart J
Pays: United States
ID NLM: 0370465
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
01
03
2019
accepted:
10
07
2019
pubmed:
17
8
2019
medline:
12
3
2020
entrez:
17
8
2019
Statut:
ppublish
Résumé
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 pressure <130 mm Hg and non-HDL cholesterol < National 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.
Identifiants
pubmed: 31419622
pii: S0002-8703(19)30180-2
doi: 10.1016/j.ahj.2019.07.005
pmc: PMC6842690
mid: NIHMS1534976
pii:
doi:
Substances chimiques
Cholesterol
97C5T2UQ7J
Banques de données
ClinicalTrials.gov
['NCT03643705']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-101Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL123341
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL137611
Pays : United States
Organisme : HSRD VA
ID : IK6 HX003161
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL142099
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI064518
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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