Patient Reported Outcomes in Routine Care: Advancing Data Capture for HIV Cohort Research

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2011 Nov 2

PMID 22042879

Citations 56

Authors

Michael S Kozak

Michael J Mugavero

Jiatao Ye

Inmaculada Aban

Sarah T Lawrence

Christa R Nevin

James L Raper

Cheryl McCullumsmith

Joseph E Schumacher

Heidi M Crane

Mari M Kitahata

Michael S Saag

James H Willig

Affiliations

Soon will be listed here.

Abstract

Introduction: Computerized collection of standardized measures of patient reported outcomes (PROs) provides a novel paradigm for data capture at the point of clinical care. Comparisons between data from PROs and Electronic Health Records (EHR) are lacking. We compare EHR and PRO for capture of depression and substance abuse and their relationship to adherence to antiretroviral therapy (ART).

Methods: This retrospective study includes HIV-positive patients at an HIV clinic who completed an initial PRO assessment April 2008-July 2009. The questionnaire includes measures of depression (PHQ-9) and substance abuse (ASSIST). Self-reported ART adherence was modeled using separate logistic regression analyses (EHR vs PRO).

Results: The study included 782 participants. EHR vs PRO diagnosis of current substance abuse was 13% (n = 99) vs 6% (n = 45) (P < .0001), and current depression was 41% (n = 317) vs 12% (n = 97) (P < .0001). In the EHR model, neither substance abuse (OR = 1.25; 95% CI = 0.70-2.21) nor depression (OR = 0.93; 95% CI = 0.62-1.40) was significantly associated with poor ART adherence. Conversely, in the PRO model, current substance abuse (OR = 2.78; 95% CI = 1.33-5.81) and current depression (OR = 1.93; 95% CI = 1.12-3.33) were associated with poor ART adherence.

Discussions: The explanatory characteristics of the PRO model correlated best with factors known to be associated with poor ART adherence (substance abuse; depression). The computerized capture of PROs as a part of routine clinical care may prove to be a complementary and potentially transformative health informatics technology for research and patient care.

Citing Articles

Developing an implementation blueprint: Lessons learned from integrating electronic patient-reported outcomes in HIV clinics in Alabama.

Gagnon K, Burgan K, Mulrain M, Baral S, Cropsey K, Mugavero M PLoS One. 2024; 19(10):e0312782.

PMID: 39475996 PMC: 11524444. DOI: 10.1371/journal.pone.0312782.

Symptomatology and Quality of Life of Older People With HIV and Comorbid Chronic Obstructive Pulmonary Diseases From an HIV Clinic in Birmingham, Alabama.

Byun J, Chapman Lambert C, Fazeli P, Iyer A, Batey D, Vance D J Assoc Nurses AIDS Care. 2024; 35(2):91-103.

PMID: 38319887 PMC: 11216896. DOI: 10.1097/JNC.0000000000000452.

Delivery of the HIV Service and Telemedicine Through Effective Patient-Reported Outcomes (+STEP) Intervention to Increase Screening and Treatment of Mental Health and Substance Use Disorders for People Living With HIV in Alabama: Protocol for an....

Gagnon K, Baral S, Long D, Guzman A, Johnson B, Burkholder G JMIR Res Protoc. 2023; 12:e40470.

PMID: 37581919 PMC: 10466153. DOI: 10.2196/40470.

Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era.

Ma J, Luu B, Ruderman S, Whitney B, Merrill J, Mixson L AIDS Care. 2023; 36(5):618-630.

PMID: 37419138 PMC: 10771542. DOI: 10.1080/09540121.2023.2223899.

Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol.

Gagnon K, Levy S, Figge C, Clevenger C, Murray L, Kane J Contemp Clin Trials Commun. 2023; 33:101123.

PMID: 37063165 PMC: 10090240. DOI: 10.1016/j.conctc.2023.101123.

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