Here’s ‘THE Course’ program in a nutshell
Here’s THE Course’ program in a nutshell
Research Triangle Park, NC-based Glaxo Wellcome Inc. has developed a behavioral modification program that consists of 12 two-hour modules to help HIV-infected people improve their medication compliance.
Called Tools for Health and Empowerment (THE) Course, the program includes the following modules:
• Who’s in charge here? This introduction to the program shows participants how to be active members of their health care teams. It includes scenarios for role-playing in which a participant has a discussion with his or her physician, and it provides an introduction to patient rights and the stages of HIV infection.
• How does HIV work? This module gives participants an introduction to the pathogenesis of HIV/AIDS. It imparts information on primary and secondary prevention and modes of HIV transmission and lists common household prevention techniques, such as hand washing, using gloves, and making a bleach solution. It also introduces participants to lab tests, home testing, viral load, and CD4 cell count.
• Emotions and HIV: Taking control. The module covers the four stages of adjusting to and accepting an HIV diagnosis. Group discussion is encouraged, and trainers teach participants positive and negative coping strategies. Plus, they cover caregiver emotional issues, and they show HIV-positive individuals how to get emotional and behavioral help from members of their health care team and community resources.
Emphasizing development of drug resistance
• Attacking the virus. This section gives a review of the HIV reproductive cycle and introduces participants to antiretroviral drugs. It provides an understanding of how antiretrovirals work on the HIV reproductive cycle, and it goes over the benefits and risks of combination therapy. It also emphasizes the significance of viral load and CD4 cell count and their relationship to therapy, survival, and disease progression. Trainers also reiterate the importance of medication adherence and the relationship between skipping doses and the development of drug-resistant HIV. Finally, this module shows how to track lab values and introduces the concept of managing one’s medications.
• Preventing opportunistic infections. Trainers discuss the relationship between CD4 cell count and the risk of acquiring opportunistic infections. This section gives participants primary and secondary prevention strategies and prophylaxis, with a special emphasis on PCP, toxo, MAC, and CMV. It also covers early recognition of signs and symptoms of opportunistic infections along with treatment options and immune reconstitution.
• Managing your medications. The module provides an understanding of which members of the health care team can help with planning and managing medications. Trainers help participants make a plan for medication adherence. And they tell participants what questions must be answered when receiving a new prescription. Trainers show participants the meaning of special instructions associated with medication schedules, and they provide opportunities for role-playing with pharmacists and providers regarding medications.
• When to call for help. This module describes how to recognize the common signs and symptoms associated with HIV and how to decide which ones need immediate attention, which ones can wait for a provider visit, and which ones can be treated at home. There’s a focus on fever, cough, weight loss, and fatigue.
• Choices in health care delivery. Trainers discuss the variety of health care delivery systems available and what each facility provides. They show participants how to best utilize health care resources in one’s community, and they discuss the different types of managed care plans.
• HIV: Your new part-time job, Part 1. This module has participants discuss returning to work and life issues. Trainers discuss funding sources, including Ryan White Care Act and ADAP, and they explain access-to-care requirements for managed care and Medicaid coverage. This session also covers problem-solving, adherence to medications on the job, and how to prevent discrimination in the workplace, along with an introduction to the Americans with Disabilities Act. Trainers also explain insurance, financial issues, employment concerns, housing issues, and disability requirements.
• HIV: Your new part-time job, Part 2. Trainers discuss patients preparing for end-of-life issues, such as wills, living wills, medical and advance directives, and durable power of attorney. They encourage participants to think about legal issues for their children and how to find allies and resources in the community. The group discusses emotions about death and dying and how to leave a legacy.
• Women and HIV. This module covers how to recognize the signs and symptoms of HIV specific to women, including how to access medical and emotional care and how to pay attention to one’s own needs. They discuss parenting, pregnancy, and contraception, and prevention of sexual transmission and reducing the possibility of maternal-fetal HIV transmission.
• Sex and drugs: Making choices. Trainers explain the primary, secondary, and tertiary prevention of HIV transmission and how to assess risk behaviors. They cover harm-reduction strategies and how alcohol and drug use relate to HIV transmission. They also provide information about resources in the community.
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