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Patient and provider comfort discussing substance use
Moira K Ray1, Mary Catherine Beach, Christina Nicolaidis
1Department of Family Medicine, and Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR 97239, USA. raymo@ohsu.edu
Family Medicine
|February 5, 2013
Summary
Patients with current substance use, who most need to discuss it, report lower comfort levels in HIV primary care. Interventions boosting patient activation and self-efficacy are key to improving these crucial conversations.
Area of Science:
- Public Health
- HIV Medicine
- Behavioral Science
Background:
- Substance use significantly impacts primary care, especially for patients with HIV.
- Effective communication about substance use is crucial for comprehensive HIV care.
Purpose of the Study:
- To identify patient and provider factors linked to comfort discussing substance use in HIV primary care settings.
- To inform interventions aimed at improving substance use discussions in this population.
Main Methods:
- Surveys assessed comfort discussing substance use among 413 patients and 44 providers.
- Multivariable logistic regression analyzed associations between patient/provider characteristics and comfort levels.
Main Results:
- Most patients (76%) and providers (73%) reported high comfort.
- Patients with current problematic alcohol or drug use had lower comfort (OR=0.5).
- Patient self-efficacy and activation positively correlated with patient comfort.
- Provider comfort was not linked to provider characteristics but to patient population demographics (e.g., proportion on antiretroviral therapy, patient activation).
Conclusions:
- Patients with current substance use, who would benefit most, are least comfortable discussing it.
- Enhancing patient activation and self-efficacy may improve comfort.
- Findings guide future interventions to promote substance use discussions in HIV care.
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