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

Heidi M. Crane, Paul K. Crane, James T. Tufano, James D. Ralston, Ira B. Wilson, Tyler D. Brown, Thomas E. Davis, Laurie F. Smith, William B. Lober, Justin McReynolds, Shireesha Dhanireddy, Robert D. Harrington, Carla V. Rodriguez, Robin M. Nance, Joseph A.C. Delaney, Steven A. Safren, Mari M. Kitahata, Rob J. Fredericksen

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3111-3121
Number of pages11
JournalAIDS and Behavior
Volume21
Issue number11
DOIs
StatePublished - Nov 1 2017

Keywords

  • Adherence
  • Alcohol use
  • Depression
  • Patient reported outcomes
  • Sexual risk behavior
  • Substance use

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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