Cost-effectiveness of a nurse-based intervention (AIMS) to improve adherence among HIV-infected patients: Design of a multi-centre randomised controlled trial

Edwin Oberje*, Marijn de Bruin, Silvia Evers, Wolfgang Viechtbauer, Hans-Erik Nobel, Herman Schaalma, Jim McCambridge, Luuk Gras, Eric Tousset, Jan Prins

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background: Non-adherence to HIV-treatment can have a negative impact on patients' treatment success rates, quality of life, infectiousness, and life expectancy. Few adherence interventions have shown positive effects on adherence and/or virologic outcomes. The theory-and evidence-based Adherence Improving self-Management Strategy (AIMS) is an intervention that has been demonstrated to improve adherence and viral suppression rates in a randomised controlled trial. However, evidence of its cost-effectiveness is lacking. Following a recent review suggesting that cost-effectiveness evaluations of adherence interventions for chronic diseases are rare, and that the methodology of such evaluations is poorly described in the literature, this manuscript presents the study protocol for a multi-centre trial evaluating the effectiveness and cost-effectiveness of AIMS among a heterogeneous sample of patients.

Methods/design: The study uses a multi-centre randomised controlled trial design to compare the AIMS intervention to usual care from a societal perspective. Embedded in this RCT is a trial-based and model-based economic evaluation. A planned number of 230 HIV-infected patients are randomised to receive either AIMS or usual care. The relevant outcomes include changes in adherence, plasma viral load, quality of life, and societal costs. The time horizon for the trial-based economic evaluation is 12-15 months. Costs and effects are extrapolated to a lifetime horizon for the model-based economic evaluation.

Discussion: The present multicentre RCT is designed to provide sound methodological evidence regarding the effectiveness and cost-effectiveness of a nurse-based counselling intervention (AIMS) to support treatment adherence among a large and heterogeneous sample of HIV-infected patients in the Netherlands. The objective of the current paper is to describe the trial protocol in sufficient detail to allow full evaluation of the quality of the study design. It is anticipated that, if proven cost-effective, AIMS can contribute to improved evidence-based counselling guidelines for HIV-nurses and other health care professionals.

Original languageEnglish
Article number274
Number of pages11
JournalBMC Health Services Research
Volume13
DOIs
Publication statusPublished - 17 Jul 2013

Fingerprint

Self Care
Cost-Benefit Analysis
Randomized Controlled Trials
Nurses
HIV
Costs and Cost Analysis
Counseling
Quality of Life
Clinical Protocols
Life Expectancy
Viral Load
Netherlands
Chronic Disease
Therapeutics
Guidelines
Delivery of Health Care

Keywords

  • adherence
  • AIMS
  • economic evaluation
  • HIV
  • intervention
  • randomised controlled trial
  • active antiretroviral therapy
  • human-immunodeficiency-virus
  • viral load
  • health
  • Haart
  • implementation
  • nonadherence
  • regimens
  • outcomes
  • cohort

Cite this

Cost-effectiveness of a nurse-based intervention (AIMS) to improve adherence among HIV-infected patients : Design of a multi-centre randomised controlled trial. / Oberje, Edwin; de Bruin, Marijn; Evers, Silvia; Viechtbauer, Wolfgang; Nobel, Hans-Erik; Schaalma, Herman; McCambridge, Jim; Gras, Luuk; Tousset, Eric; Prins, Jan.

In: BMC Health Services Research, Vol. 13, 274, 17.07.2013.

Research output: Contribution to journalArticle

Oberje, Edwin ; de Bruin, Marijn ; Evers, Silvia ; Viechtbauer, Wolfgang ; Nobel, Hans-Erik ; Schaalma, Herman ; McCambridge, Jim ; Gras, Luuk ; Tousset, Eric ; Prins, Jan. / Cost-effectiveness of a nurse-based intervention (AIMS) to improve adherence among HIV-infected patients : Design of a multi-centre randomised controlled trial. In: BMC Health Services Research. 2013 ; Vol. 13.
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