Randomized Study of Interventions to Enhance Adherence to Isoniazid Prevention Therapy for Tuberculosis in Injection Drug Users - Full Text View

Sponsors and Collaborators:	National Institute on Drug Abuse (NIDA) Johns Hopkins University
Information provided by:	Office of Rare Diseases (ORD)
ClinicalTrials.gov Identifier:	NCT00004740

Purpose

OBJECTIVES: I. Recruit 300 injection drug users with positive tuberculin skin tests who are candidates for isoniazid chemoprophylaxis into a trial of several interventions to enhance adherence to preventive therapy. II. Compare the effectiveness of self-administered isoniazid chemoprophylaxis supplemented with peer education and support groups versus directly observed preventive therapy delivered by a licensed nurse versus self-administered therapy with standard clinic follow-up and education.

Outcome measures are adherence to prescribed doses of medication and the proportion of patients who complete therapy.

III. Compare the impact of monetary incentives on therapy adherence by random assignment to immediate vs. deferred financial incentive.

IV. Assess attitudes, knowledge, and beliefs about tuberculosis and preventive therapy in these patients and determine the association of these factors with demographic, social, and clinical characteristics. V. Assess attitudes and beliefs about tuberculosis susceptibility, seriousness, benefits of preventive therapy, barriers to therapy, and self-efficacy as predictors of health-related behaviors as measured by adherence with therapy, and determine the impact of the assigned interventions on these attitudes and beliefs.

Condition	Intervention
Tuberculosis	Drug: isoniazid

MedlinePlus related topics: Tuberculosis

Drug Information available for: Isoniazid Ftivazide

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Prevention, Randomized, Open Label

Further study details as provided by Office of Rare Diseases (ORD):

Estimated Enrollment:	300
Study Start Date:	February 1995

Detailed Description:

PROTOCOL OUTLINE: This is a randomized study. Patients in the first group self-administer oral isoniazid following the standard clinic protocol for 6 months. They receive individual counseling and education by a peer educator at entry and at week 2, participate in a monthly support group cofacilitated by a peer counselor and health educator, and make a monthly clinic visit. Patients in the second group receive oral isoniazid twice a week. Therapy is administered by the nurse, who observes ingestion and swallowing.

Nursing education and support per standard clinic procedures is provided at each monthly clinic visit.

Patients in the third group self-administer oral isoniazid, without enhanced education and peer support, following the standard clinic protocol for 6 months. Nursing education and support per standard clinic procedures is provided at each monthly clinic visit.

Within each group, patients are randomly assigned to an immediate or deferred financial compensation schedule. Immediate compensation for compliance with medication and clinical visit is given during the monthly clinic visit, while deferred compensation is given at study completion.

It is recommended that HIV-seropositive patients receive 6 additional months of standard isoniazid therapy.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

PROTOCOL ENTRY CRITERIA:

Population Characteristics

Positive purified protein derivative (PPD) tuberculin skin test, with induration as follows: 10 mm or greater if HIV seronegative 5 mm or greater if HIV seropositive or status unknown
No active tuberculosis (TB) on chest x-ray
Candidate for isoniazid prophylaxis through Baltimore City Health Department
Active or treated injection drug user, i.e.: Injected illicit drugs within the last 3 months OR Previously injected drugs and is in drug treatment
Injection use documented by: Subject self report Medical and referral records from drug treatment programs Physical exam for stigmata of injection drug use

Prior/Concurrent Therapy

No more than 6 months of prior TB preventive therapy for HIV

Subject Characteristics

Hepatic: ALT no greater than 3 x ULN
Renal: Not specified
Other: No prior serious adverse reaction to isoniazid No requirement for HIV therapy other than Pneumocystis prophylaxis or antiretrovirals

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00004740

Sponsors and Collaborators

National Institute on Drug Abuse (NIDA)

Johns Hopkins University

Investigators

Study Chair:

Richard E. Chaisson

Johns Hopkins University

More Information

No publications provided

Study ID Numbers:	199/11642, JHUSM-93090801
Study First Received:	February 24, 2000
Last Updated:	June 23, 2005
ClinicalTrials.gov Identifier:	NCT00004740 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by Office of Rare Diseases (ORD):

cardiovascular and respiratory diseases
rare disease
tuberculosis

Study placed in the following topic categories:

Antimetabolites
Bacterial Infections
Anti-Bacterial Agents
Gram-Positive Bacterial Infections
Antilipemic Agents
Respiration Disorders

Rare Diseases
Mycobacterium Infections
Tuberculosis
Antitubercular Agents
Isoniazid

Additional relevant MeSH terms:

Bacterial Infections
Antimetabolites
Anti-Infective Agents
Molecular Mechanisms of Pharmacological Action
Antilipemic Agents
Actinomycetales Infections
Pharmacologic Actions
Anti-Bacterial Agents

Gram-Positive Bacterial Infections
Therapeutic Uses
Mycobacterium Infections
Tuberculosis
Antitubercular Agents
Fatty Acid Synthesis Inhibitors
Isoniazid

ClinicalTrials.gov processed this record on May 07, 2009