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A Nurse-led Intervention to Extend the Veteran HIV Treatment Cascade for Cardiovascular Disease Prevention

CompletedNA

Sponsor: VA Office of Research and Development

Conditions: Cardiovascular Disease, Hypertension, Care Coordination, HIV Treatment Cascade

Interventions: Intervention group, Education control group

Countries: United States

The VA is the largest single provider of HIV care in the US and Veterans with HIV use significantly more healthcare services and have a 1.5-2x higher risk of atherosclerotic cardiovascular disease (ASCVD) compared to uninfected Veterans. The goal is to improve BP treatment for Veterans with HIV to reduce ASCVD risk. Within a randomized controlled trial (RCT), the investigators hypothesize that the VA adapted nurse-led intervention will result in a clinically significant 6 millimeters of mercury (mmHg) reduction in systolic blood pressure (SBP) over 12 months compared to those receiving enhanced education only. The study is innovative because of the use of stakeholder-engaged design process, multi-component nurse-led intervention, and VA Video Connect (VVC) to monitor CVD risk factors. The project meets VA strategic priorities including: 1) greater choice for Veterans; 2) improve timeliness of services; 3) focus more resources more efficiently (strengthen foundational services in VA). If shown to be effective, this intervention will have substantial impact among high-risk Veterans, potentially reducing ASCVD events by more than a quarter.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria

Inclusion Criteria:

1. Age =\> 18 years
2. Confirmed HIV+ diagnosis
3. Undetectable HIV viral load: defined as the most recent HIV viral load \< 200 copies/mL, checked within the past 18 months (assessed via chart abstraction)
4. Hypertension: defined as the average of 4 most recent outpatient BP measurements in the last 18 months to show systolic BP 130 and/or diastolic 90 mmHg (assessed via chart abstraction)
5. Veteran at one of the sites participating in the study
6. Regular access to a computer, tablet or smart phone device with internet.

Exclusion Criteria:

1. Severely hearing or speech impaired, or other disability that would limit participation
2. In a nursing home at baseline and/or any long-term care facility. Individuals will be censored at the point of entering nursing home care
3. In-patient psychiatric care
4. Diagnosis of dementia or active psychosis
5. Terminal illness with life expectancy \< 4 months (ex. Metastatic cancer, Hospice care)
6. Recent (\<90day) hospitalization for coronary artery bypass surgery (CABG), myocardial infarction (MI), stroke)
7. Pregnant, breast-feeding, or planning a pregnancy during the study period
8. Planning to move out of the area in the next 12 months.
9. No reliable access to telephone services

Locations (4)

Decatur, Georgia, United States
Baltimore, Maryland, United States
Durham, North Carolina, United States
Cleveland, Ohio, United States