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Breakout 8: HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study. AHSR 2005 Annual Conference. Jerry Flanzer, Moderator. Section A. Brief Overview of the “ Cost Study ” : Status and Untapped Potential. Jerry Flanzer, NIDA Ali Manwar, CSAT James Bell, James Bell Associates.
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Breakout 8: HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study AHSR 2005 Annual Conference Jerry Flanzer, Moderator
Section A Brief Overview of the “Cost Study”: Status and Untapped Potential Jerry Flanzer, NIDA Ali Manwar, CSAT James Bell, James Bell Associates
Ground Breaking The first United States Federal effort to focus on people living with HIV/AIDS who also have a diagnosed mental health and substance use disorder.
Six Collaborating Federal Agencies • NIH-National Institute on Drug Abuse • NIH-National Institute on Alcohol Abuse and Alcoholism • NIMH-National Institute of Mental Health • SAMHSA-Center for Mental Health Services • SAMHSA-Center for Substance Abuse Treatment • HRSA-HIV/AIDS Bureau
Principal Investigators and Sites • Marcia Andersen, Well-Being Institute, Detroit, MI; • Robert Calsyn, University of Missouri, St. Louis, MO; • Terence Keane, Boston University School of Medicine, Boston, MA; • Stanley Sacks, National Development & Research Institutes, Inc., Philadelphia, PA; • Tomas Soto, Cook County Bureau of Health Services/CORE Center, Chicago, IL; • Karina Uldall, University of Washington, Seattle, WA; • Mark Winiarski, Montefiore Medical Center, Bronx, NY; • Kathryn Whetten, Duke University, Durham, NC; • James Bell, Coordinating Center, James Bell Associates, Arlington, VA.
Cost Study Overview • A multi-site cooperative research program to investigate integrated treatment interventions for persons living with HIV and co-occurring mental and substance use disorders. • Tested heterogeneous models of integrated care suited to local delivery system features and Site preferences for intervention approach (seven RCTs). • Research interview data was collected on clinical diagnosis, symptom severity, medication adherence, demographics, socio-economic characteristics, and service utilization at baseline, 3-, 6-, 9- and 12-month intervals for a convenience sample of 1138 cases (all Sites). - The Client Assessment Data Base will be made available for public use; as will an Intervention Service Record (ISR) Data Base that is linked with the Client Assessment Data Base through a unique case identifier.
Study Status and Next Steps – Focus on highly vulnerable disadvantaged population. – Broad and deep data that meets high standards for measurement quality. – Convenience sample of 1138 cases split between experimental integrated treatment interventions and care-as-usual controls at eight Sites. – Most important findings on outcomes are undetermined, as yet. – Seminal papers have or will address, individually and collectively, topics, such as the following: effects of integrated treatment interventions on HIV and psychiatric medication adherence, physical health status, mental health status, and substance abuse status; correlates of entry and retention in integrated and standard medical and behavioral health care; and health care services utilization and cost. – Untapped potential to inform a much needed new paradigm of care for persons living with HIV and complex co-occurring disorders (the shift to chronic disease management). • The HIV/AIDS Cost Study Data Bases should be available for public use within 12 months. To find out more about these data, and currently planned publications, please contact James Bell (bell@jbassoc.com) or Cheryl McDonnell (mcdonnell@jbassoc.com).