Antiretroviral Improvement Among Medicaid Enrollees

Virginia Commonwealth University4 enrolled

Overview

This study will evaluate whether a new program will affect how often human immunodeficiency virus (HIV) antiretroviral therapy (ART) prescriptions are filled and whether the program improves the health of people living with HIV.

Virginia Commonwealth University and study collaborators are working together to learn about challenges that Virginia Medicaid members have in taking their prescribed medication. To do this, the researchers are implementing and evaluating a program called Antiretroviral Improvement among Medicaid enrolleeS (AIMS). This program is designed to support members to fill ART prescriptions. The program involves supporting Medicaid members with HIV directly by talking to them about challenges with filling their ART prescriptions and linking them to resources that can help with those challenges. Some members will be offered access to warm health technology support. The researchers think this support may increase how often ART prescriptions are filled and hope that the AIMS program can improve individuals' health and increase HIV viral suppression.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Human Immunodeficiency Virus

Interventions

Experimental: AIMS program - patientBEHAVIORAL

Patient-level support will be offered to eligible Virginia Medicaid enrollees who have a late ART prescription refill(s) by \>30 days. Support will come from the provider, pharmacy, managed care organization or the community. Patient-level support will involve direct linkages and referrals for participants with a late ART prescription refill(s) \>30-60 days. Support will intensify as the gap in ART prescription(s) fills increases. For those with a late ART prescription refill(s) for \>60 days, added patient-level support will include warm health technology via PositiveLinks, a mobile app program promoting better health through self-monitoring tools, educational resources, direct messaging with program staff and a confidential user community board.

No Intervention/Usual careOTHER

Participants in the usual care arm will receive standard state-level care for late ART prescription refill(s) for Virginia Medicaid enrollees living with HIV.

Eligibility

Sex: ALLMin age: 19 YearsMax age: 64 Years

Medical Language ↔ Plain English

Inclusion criteria: * Current enrollment in Virginia Medicaid; * Continuous Virginia Medicaid enrollment for the preceding 9 or more months; * Current age 19-64 years; * Identified as living with HIV according to an HIV case identification algorithm; * Non-dual eligible for Medicare; * History of ART prescription claim(s) within the past 12 months; * Prior ART prescription claim, with claims for the most recent ART prescription refill(s) \>30 days late. Exclusion criteria: * Record of non-Medicaid health insurance or other health care service payer in past 3 months; * New prescription claim(s) within 30 days for within-class ART drug(s) not previously prescribed; * Service claim(s) for resistance testing and other ART prescription claim(s) within 30 days of most recent late ART prescription(s) for ART drug(s) not previously prescribed; * Enrollee's linked HIV provider practices at a healthcare facility offering PositiveLinks; * No record in the Virginia HIV surveillance data; * Non-English speaking.

Locations (1)

Virginia Commonwealth University

Richmond, Virginia, United States

Outcomes

Primary Outcomes

Number and Percentage of Participants Virally Suppressed

HIV viral load data come from Virginia Department of Health (VDH) routine surveillance. Viral load data indicate whether or not an individual was virally suppressed, i.e., the level of HIV in a blood sample was less than the detectable limit.

Time frame: 3 months

Secondary Outcomes

Number and Percentage of Participants Reinitiating Late Antiretroviral Therapy (ART) Prescription

Data source is prescription claim(s) for antiretroviral therapy (ART) prescription(s) made available through Virginia Medicaid. Participants will be considered as reinitiating if they have a filled ART prescription after study enrollment.

Time frame: 3 months

Antiretroviral Therapy (ART) Adherence

Data source is prescription claim(s) for antiretroviral therapy (ART) made available through Virginia Medicaid. Participants will be considered adherent if their ART prescription claim(s) cover \>90% of enrolled coverage days.

Time frame: 3 months

Data from ClinicalTrials.gov

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