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

doi:10.1007/s10461-017-1718-5

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

Journal article

Open access

Peer reviewed

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, …

AIDS and behavior, Vol.21(11), pp.3111-3121

2017-11

DOI: https://doi.org/10.1007/s10461-017-1718-5

PMCID: PMC6021024

PMID: 28205041

Abstract

Adherence

Substance use

Sexual risk behavior

Depression

Patient reported outcomes

Alcohol use

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.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.66 HIV; 1.66.11 HIV Prevalence & Prophylaxis
Web Of Science research areas: Public, Environmental & Occupational Health; Social Sciences, Biomedical
ESI research areas: Psychiatry/Psychology

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Title: HIV Provider Documentation and Actions Following Patient Reports of At-risk Behaviors and Conditions When Identified by a Web-Based Point-of-Care Assessment
Creators: Heidi M Crane - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA. hcrane@uw.edu
Paul K Crane - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
James T Tufano - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
James D Ralston - Department of Medicine, Group Health Cooperative, Seattle, WA, USA
Ira B Wilson - Chair of Health Services, Policy and Practice, Brown University, Providence, RI, USA
Tyler D Brown - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Thomas E Davis - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Laurie F Smith - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
William B Lober - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Justin McReynolds - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Shireesha Dhanireddy - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Robert D Harrington - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Carla V Rodriguez - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Robin M Nance - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Joseph A C Delaney - Department of Epidemiology, University of Washington, Seattle, WA, USA
Steven A Safren - University of Miami, Miami, FL, USA
Mari M Kitahata - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Rob J Fredericksen - Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA
Publication Details: AIDS and behavior, Vol.21(11), pp.3111-3121
Publisher: United States
Grant note: U54 GM115677 / NIGMS NIH HHS R24 AI067039 / NIAID NIH HHS P30 AI042853 / NIAID NIH HHS U01 AA020793 / NIAAA NIH HHS U24 AA020801 / NIAAA NIH HHS U01 AR057954 / NIAMS NIH HHS K23 AI060464 / NIAID NIH HHS R01 MH084759 / NIMH NIH HHS P30 AI027757 / NIAID NIH HHS
Academic Unit: College of A&S; A&S - Psychology
Language: English
Resource Type: Journal article
PMID: 28205041
PMCID: PMC6021024
Record Identifier: 991031576965202976