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首页> 外文学位 >Role of acupuncture as an adjuvant therapy in the treatment of HIV/AIDS: Examining disparities in access, cost-effectiveness of using acupuncture as a promoter of adherence to antiretroviral treatment, and public health considerations.
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Role of acupuncture as an adjuvant therapy in the treatment of HIV/AIDS: Examining disparities in access, cost-effectiveness of using acupuncture as a promoter of adherence to antiretroviral treatment, and public health considerations.

机译：针灸作为辅助疗法在治疗HIV / AIDS中的作用：研究在获取方面的差异，使用针灸作为抗逆转录病毒治疗依从性的促进剂的成本效益以及公共卫生方面的考虑。

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摘要

Background: The use of acupuncture in the U.S. by individuals living with HIV/AIDS represents a new area of clinical and academic study. Since many individuals turn to acupuncture for relief of side-effects related to their use of antiretroviral medication, examining this aspect of care is of special therapeutic, public health, and economic interest. In the three papers of this dissertation, I address the use of acupuncture as an adjuvant to medical care, particularly focused on its role in side-effect management and promoting medication adherence. Concomitant economic ramifications and interdependencies between quality of life and treatment adherence are also explored, as well as potential disparities in access to acupuncture related to changes in federal funding.;Methods: The first paper (Dynamic Interplay of Adherence to HIV-medication, Quality of Life, and Side Effect Management) examines a conceptual model that may be useful for understanding these dynamic inter-relationships. The second paper (Cost-effectiveness of Acupuncture to Improve and Sustain Adherence to Antiretroviral Therapy) explores cost-effectiveness of enhanced adherence and compares associated costs and health outcomes resulting from using acupuncture in order to optimize adherence to antiretroviral therapy. The last paper (Examining Changes in Utilization of Acupuncture Care Related to Reduction in Ryan White Care Act Funding) addresses the issue of utilization and uses bivariate and multivariate analyses to explore disparities associated with demographic and behavioral issues. Both the second and third papers use data from retrospective medical record review.;Results: Records of approximately 1100 patients were included in the analyses. Cost-effectiveness estimates were found to be consistent with costs of other interventions to promote adherence to antiretroviral therapy previously reported in the literature. Although disparities in utilization of acupuncture were noted for female patients and for those reporting use of alcohol, small sample size may have hampered the study's ability to detect meaningful differences.;Recommendations: The use of acupuncture as an adjuvant to HIV/AIDS care merits clinical and research interest. Although limitations of these analyses were evident, results indicate that acupuncture may offer therapeutic benefit through promoting adherence to antiretroviral therapy. Continued outreach services for all aspects of care to women living with HIV/AIDS seemingly remain important.
机译：背景：艾滋病毒/艾滋病感染者在美国使用针灸是临床和学术研究的新领域。由于许多人为了减轻与使用抗逆转录病毒药物相关的副作用而转向针灸，因此检查护理的这一方面具有特殊的治疗意义，公共卫生和经济意义。在本论文的三篇论文中，我着重介绍了针灸作为医疗保健辅助剂的用途，特别着重于针灸在副作用管理和促进药物依从性方面的作用。还探讨了伴随的经济后果和生活质量与治疗依从性之间的相互依存关系，以及与联邦拨款变化有关的针灸获取方面的潜在差异。方法：第一篇论文（坚持服药艾滋病毒的动态相互作用，生活和副作用管理）研究了一种概念模型，该模型可能有助于理解这些动态的相互关系。第二篇论文（《针灸改善和维持抗逆转录病毒疗法的依从性的成本效益》）探讨了增强依从性的成本效益，并比较了针灸以优化对抗逆转录病毒疗法的依从性产生的相关成本和健康结果。最后一篇论文（《瑞安《白色护理法》资助中与减少针灸相关的使用变化的研究》）探讨了使用问题，并使用双变量和多变量分析来探索与人口统计学和行为问题相关的差异。第二篇和第三篇论文均使用回顾性病历审查的数据。结果：分析中包括约1100名患者的病历。发现成本效益估计与先前文献中报道的其他促进抗逆转录病毒疗法依从性的干预措施的成本一致。尽管注意到女性患者和报告使用酒精的患者使用针灸的差异，但小样本量可能会妨碍研究发现有意义差异的能力。;建议：使用针灸作为HIV / AIDS护理的佐剂值得临床和研究兴趣。尽管这些分析的局限性显而易见，但结果表明，针灸可通过促进对抗逆转录病毒疗法的依从性提供治疗益处。继续为感染艾滋病毒/艾滋病的妇女提供所有护理方面的外联服务似乎仍然很重要。

著录项

  • 作者

    Sommers, Elizabeth Ann.;

  • 作者单位

    Boston University.;

  • 授予单位 Boston University.;
  • 学科 Health Sciences Alternative Medicine.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 127 p.
  • 总页数 127
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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