A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial

A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial

Background: Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV. Objective: Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ASCVD risk among people living with HIV (PW...

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Main Authors: Lewis Musoke, Hayden B. Bosworth, Christina Dickson, Pamela Gentry, Elizabeth Strawbridge, Soumya Subramaniam, Jennifer Gierisch, Valerie Smith, Sandra Woolson, John Pura, Willington Amutuhaire, Susanna Naggie, Julie Schexnayder, Karen Hall, Chris T. Longenecker, Nadine M. Harris, Chantrice Rogers, Puja Van Epps, for V-EXTRA-CVD Group
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:HIV Research & Clinical Practice
Subjects:
hiv
cholesterol
hypertension
atherosclerotic cardiovascular disease
Online Access:http://dx.doi.org/10.1080/25787489.2023.2261747
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Summary:Background: Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV. Objective: Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ASCVD risk among people living with HIV (PWH). We aim to conduct a randomized control trial among PWH (n = 300) with a diagnosis of hypertension (HTN) who are enrolled in Veterans Health Administration (VHA) clinics, on suppressive antiretroviral therapy (ART), randomized 1:1 to intervention vs. education control for a 12-month duration. Methods: Using human centered design approach, we have adapted a previous 5-component telehealth focused, non-physician led intervention to a Veteran population. The education control arm receives enhanced education in addition to usual care. The primary outcome is 6 mmHg reduction in systolic BP over 12-month in the intervention arm compared to the control arm. The secondary outcome is a 12-month difference in non-HDL cholesterol. While each component of our intervention has an evidence base, they have not been tested together in an HIV context. Conclusion: The proposed multicomponent intervention has the potential to improve cardiovascular outcomes in PWH using novel virtual care methods in a patient centered care approach.
ISSN:2578-7470

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