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Development and field testing of an HIV medication touch screen computer patient adherence tool with telephone-based,
D Keith McInnes1, Hélène Hardy, Matthew B Goetz
1VA QUERI Program and Center for Health Quality, Outcomes and Economic Research, VA New England Healthcare System, Bedford, MA, USA.
Background:
HIV medication nonadherence is a major problem, yet many providers lack the time and training to carefully ask patients about their adherence.
Objective:
To design and pilot a technology-assisted intervention, for use in clinical settings, to identify nonadherent patients.
Methods:
The intervention uses audio computer-assisted self-interview (ACASI) to improve the assessment of adherence and medication-related problems. Patients completed a touch screen computer ACASI which generated graphic clinician and patient reports for discussion during the clinical encounter.
Results:
72 patients and 11 providers participated in this study. The patients easily completed the ACASI. Adherence was 63% (3-day) and 47% (30-day). Using the ACASI, 22% of patients identified themselves as nonadherent, when their providers perceived them as adherent.
Conclusions:
This ACASI-based intervention is easy to use and helps identify nonadherence. The pilot test engendered enhancements including the addition of phone-based adherence counseling. A larger trial is underway to evaluate whether the intervention leads to improved HIV-related outcomes.
