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[Agency] AHRQ-Indian Health Service [Project Title] Comparative Effectiveness of Lipid-Lowering and Antihypertensive Medications Among HIV-Infected Individuals [Institution] UNIVERSITY OF WASHINGTON [Amount] $0 [Summary] The goal of this project is to evaluate the comparative effectiveness of lipid-lowering and antihypertensive medications among HIV-infected individuals. HIV infection itself may impact metabolic abnormalities such as dyslipidemia leading to cardiovascular disease risk. In addition, the decline in mortality in the developed world for HIV-infected patients resulting from widespread use of highly active antiretroviral therapy has been accompanied by an increase in metabolic complications such as dyslipidemia and hypertension which can result in significant morbidity among HIV-infected individuals including cardiovascular disease, the leading cause of death and morbidity in the US. However, despite the increasing importance of these chronic conditions, uncertainty exists regarding management choices in clinical practice. We plan to use innovative statistical techniques including marginal structural models to account for time dependant confounding and inverse intensity rate ratio-weighted (IIRR) generalized estimating equations to account for the non structured visit schedule to estimate the comparative effectiveness of medications in the treatment of HIV- infected individuals. We will capitalize on the comprehensive clinical data available within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS). This study addresses an important question that will impact provider decision-making regarding lipid-lowering and antihypertensive medications and, as a result, improve the clinical care of HIV-infected patients. In addition, this project will advance the methods available for comparative effectiveness analyses in observational settings. Improving these techniques has the potential to improve studies of comparative medication effectiveness studies for other conditions (beyond that of the HIV-infected patients). [Completion/ Closing Date] 10/02/2010 [Link] link [Category] 
Medical treatments, items and services
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