HIV Provider Documentation and Actions Following Patient Reports of At-risk Behaviors and Conditions When Identified by a Web-Based Point-of-Care Assessment

We compared same-day provider medical record documentation and interventions addressing depression and risk behaviors before and after delivering point-of-care patient-reported outcomes (PROs) feedback for patients who self-reported clinically relevant levels of depression or risk behaviors. During...

Full description

Saved in:
Bibliographic Details
Published in:AIDS and behavior 2017-11, Vol.21 (11), p.3111-3121
Main Authors: Crane, Heidi M., Crane, Paul K., Tufano, James T., Ralston, James D., Wilson, Ira B., Brown, Tyler D., Davis, Thomas E., Smith, Laurie F., Lober, William B., McReynolds, Justin, Dhanireddy, Shireesha, Harrington, Robert D., Rodriguez, Carla V., Nance, Robin M., Delaney, Joseph A. C., Safren, Steven A., Kitahata, Mari M., Fredericksen, Rob J.
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adhesion
AIDS
Alcohol use
Alcoholic beverages
Assessments
Consciousness
Documentation
Feedback
Health Psychology
HIV
Human immunodeficiency virus
Infectious Diseases
Intervention
Medicine
Medicine & Public Health
Mental depression
Original Paper
Patient compliance
Patients
Public Health
Risk assessment
Risk behavior
Risk taking
Substance abuse
Substance use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We compared same-day provider medical record documentation and interventions addressing depression and risk behaviors before and after delivering point-of-care patient-reported outcomes (PROs) feedback for patients who self-reported clinically relevant levels of depression or risk behaviors. During the study period (1 January 2006–15 October 2010), 2289 PRO assessments were completed by HIV-infected patients. Comparing the 8 months before versus after feedback implementation, providers were more likely to document depression (74% before vs. 87% after feedback, p = 0.02) in patients with moderate-to-severe depression (n = 317 assessments), at-risk alcohol use (41 vs. 64%, p = 0.04, n = 155) and substance use (60 vs. 80%, p = 0.004, n = 212). Providers were less likely to incorrectly document good adherence among patients with inadequate adherence after feedback (42 vs. 24%, p = 0.02, n = 205). While PRO feedback of depression and adherence were followed by increased provider intervention, other domains were not. Further investigation of factors associated with the gap between awareness and intervention are needed in order to bridge this divide.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-017-1718-5