Translating clinical trial results into practice: The effect of an AIDS Clinical Trial on prescribed antiretroviral therapy for HIV-infected pregnant women

Barbara J. Turner, Craig Newschaffer, Daozhi Zhang, Thomas Fanning, Walter W. Hauck

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: The success of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 in preventing vertical HIV transmission prompted intensive efforts to inform lay-persons and professionals about the trial's results. Objective: To explore community responsiveness to these efforts by assessing temporal, maternal, and health care factors associated with prescribed antiretroviral therapy before and after PACTG Protocol 076. Design: Retrospective cohort study. Setting: New York State Medicaid program. Patients: 2607 HIV-infected women who delivered a living child between January 1993 and September 1996. Measurements: Adjusted odds of being prescribed antiretroviral treatment in the second or third trimester for women who delivered in period 1 (during the trial [January 1993 to February 1994]), period 2 (after the trial's end and announcement of the results to publication of the results [March 1994 to November 1994]), and period 3 (after publication of the trial results [December 1994 to September 1996]). Results: The adjusted odds of being prescribed antiretroviral therapy increased 21% per month in period 2 and decreased to 3% per month in period 3. In all time periods, the adjusted odds of being prescribed antiretroviral therapy were at least 60% greater (P<0.05) for women who were treated at an institution that performed HIV clinical trials, received HIV-focused ambulatory care, or had adequate prenatal care visits. After the trial, women receiving methadone treatment had at least twofold (95% Cl, 1.5- to 4.3- fold) greater adjusted odds of being prescribed antiretroviral therapy than women who did not take any illicit drugs. Latin-America woman, older women, and women born in the United States had greater adjusted odds (P<0.05) of being prescribed treatment in period 3. Conclusion: Community practice responded rapidly to efforts to disseminate the results of PACTG Protocol 076; however, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that performed clinical trials, or methadone therapy.

Original languageEnglish (US)
Pages (from-to)979-986
Number of pages8
JournalAnnals of internal medicine
Volume130
Issue number12
DOIs
StatePublished - Jun 15 1999

Fingerprint

Pregnant Women
Acquired Immunodeficiency Syndrome
Clinical Trials
HIV
Clinical Protocols
Therapeutics
Methadone
Pediatrics
Publications
Prenatal Care
Latin America
Medicaid
Third Pregnancy Trimester
Street Drugs
Second Pregnancy Trimester
Ambulatory Care
Cohort Studies
Retrospective Studies
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

@article{1f891464caa14d409c0dc61b633050cf,
title = "Translating clinical trial results into practice: The effect of an AIDS Clinical Trial on prescribed antiretroviral therapy for HIV-infected pregnant women",
abstract = "Background: The success of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 in preventing vertical HIV transmission prompted intensive efforts to inform lay-persons and professionals about the trial's results. Objective: To explore community responsiveness to these efforts by assessing temporal, maternal, and health care factors associated with prescribed antiretroviral therapy before and after PACTG Protocol 076. Design: Retrospective cohort study. Setting: New York State Medicaid program. Patients: 2607 HIV-infected women who delivered a living child between January 1993 and September 1996. Measurements: Adjusted odds of being prescribed antiretroviral treatment in the second or third trimester for women who delivered in period 1 (during the trial [January 1993 to February 1994]), period 2 (after the trial's end and announcement of the results to publication of the results [March 1994 to November 1994]), and period 3 (after publication of the trial results [December 1994 to September 1996]). Results: The adjusted odds of being prescribed antiretroviral therapy increased 21{\%} per month in period 2 and decreased to 3{\%} per month in period 3. In all time periods, the adjusted odds of being prescribed antiretroviral therapy were at least 60{\%} greater (P<0.05) for women who were treated at an institution that performed HIV clinical trials, received HIV-focused ambulatory care, or had adequate prenatal care visits. After the trial, women receiving methadone treatment had at least twofold (95{\%} Cl, 1.5- to 4.3- fold) greater adjusted odds of being prescribed antiretroviral therapy than women who did not take any illicit drugs. Latin-America woman, older women, and women born in the United States had greater adjusted odds (P<0.05) of being prescribed treatment in period 3. Conclusion: Community practice responded rapidly to efforts to disseminate the results of PACTG Protocol 076; however, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that performed clinical trials, or methadone therapy.",
author = "Turner, {Barbara J.} and Craig Newschaffer and Daozhi Zhang and Thomas Fanning and Hauck, {Walter W.}",
year = "1999",
month = "6",
day = "15",
doi = "10.7326/0003-4819-130-12-199906150-00005",
language = "English (US)",
volume = "130",
pages = "979--986",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "12",

}

Translating clinical trial results into practice : The effect of an AIDS Clinical Trial on prescribed antiretroviral therapy for HIV-infected pregnant women. / Turner, Barbara J.; Newschaffer, Craig; Zhang, Daozhi; Fanning, Thomas; Hauck, Walter W.

In: Annals of internal medicine, Vol. 130, No. 12, 15.06.1999, p. 979-986.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Translating clinical trial results into practice

T2 - The effect of an AIDS Clinical Trial on prescribed antiretroviral therapy for HIV-infected pregnant women

AU - Turner, Barbara J.

AU - Newschaffer, Craig

AU - Zhang, Daozhi

AU - Fanning, Thomas

AU - Hauck, Walter W.

PY - 1999/6/15

Y1 - 1999/6/15

N2 - Background: The success of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 in preventing vertical HIV transmission prompted intensive efforts to inform lay-persons and professionals about the trial's results. Objective: To explore community responsiveness to these efforts by assessing temporal, maternal, and health care factors associated with prescribed antiretroviral therapy before and after PACTG Protocol 076. Design: Retrospective cohort study. Setting: New York State Medicaid program. Patients: 2607 HIV-infected women who delivered a living child between January 1993 and September 1996. Measurements: Adjusted odds of being prescribed antiretroviral treatment in the second or third trimester for women who delivered in period 1 (during the trial [January 1993 to February 1994]), period 2 (after the trial's end and announcement of the results to publication of the results [March 1994 to November 1994]), and period 3 (after publication of the trial results [December 1994 to September 1996]). Results: The adjusted odds of being prescribed antiretroviral therapy increased 21% per month in period 2 and decreased to 3% per month in period 3. In all time periods, the adjusted odds of being prescribed antiretroviral therapy were at least 60% greater (P<0.05) for women who were treated at an institution that performed HIV clinical trials, received HIV-focused ambulatory care, or had adequate prenatal care visits. After the trial, women receiving methadone treatment had at least twofold (95% Cl, 1.5- to 4.3- fold) greater adjusted odds of being prescribed antiretroviral therapy than women who did not take any illicit drugs. Latin-America woman, older women, and women born in the United States had greater adjusted odds (P<0.05) of being prescribed treatment in period 3. Conclusion: Community practice responded rapidly to efforts to disseminate the results of PACTG Protocol 076; however, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that performed clinical trials, or methadone therapy.

AB - Background: The success of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 in preventing vertical HIV transmission prompted intensive efforts to inform lay-persons and professionals about the trial's results. Objective: To explore community responsiveness to these efforts by assessing temporal, maternal, and health care factors associated with prescribed antiretroviral therapy before and after PACTG Protocol 076. Design: Retrospective cohort study. Setting: New York State Medicaid program. Patients: 2607 HIV-infected women who delivered a living child between January 1993 and September 1996. Measurements: Adjusted odds of being prescribed antiretroviral treatment in the second or third trimester for women who delivered in period 1 (during the trial [January 1993 to February 1994]), period 2 (after the trial's end and announcement of the results to publication of the results [March 1994 to November 1994]), and period 3 (after publication of the trial results [December 1994 to September 1996]). Results: The adjusted odds of being prescribed antiretroviral therapy increased 21% per month in period 2 and decreased to 3% per month in period 3. In all time periods, the adjusted odds of being prescribed antiretroviral therapy were at least 60% greater (P<0.05) for women who were treated at an institution that performed HIV clinical trials, received HIV-focused ambulatory care, or had adequate prenatal care visits. After the trial, women receiving methadone treatment had at least twofold (95% Cl, 1.5- to 4.3- fold) greater adjusted odds of being prescribed antiretroviral therapy than women who did not take any illicit drugs. Latin-America woman, older women, and women born in the United States had greater adjusted odds (P<0.05) of being prescribed treatment in period 3. Conclusion: Community practice responded rapidly to efforts to disseminate the results of PACTG Protocol 076; however, the absolute increase in prescribed therapy was greatest for women who had adequate prenatal visits or were receiving HIV-focused care, care at a site that performed clinical trials, or methadone therapy.

UR - http://www.scopus.com/inward/record.url?scp=0033564516&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033564516&partnerID=8YFLogxK

U2 - 10.7326/0003-4819-130-12-199906150-00005

DO - 10.7326/0003-4819-130-12-199906150-00005

M3 - Article

C2 - 10383368

AN - SCOPUS:0033564516

VL - 130

SP - 979

EP - 986

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 12

ER -