Physicians' Recognition of the Symptoms Experienced by HIV Patients

Abstract

To assess how well physicians recognize common symptoms in HIV patients and identify factors associated with symptom recognition, a multicenter cross-sectional survey was performed in a random sample of 118 hospitalized and 172 ambulatory HIV patients, and their attending physicians. Patients' reports of 16 different symptoms were compared to physicians' reports of whether each symptom was present and/or specific treatments prescribed. Overall, fatigue, anxiety, skin problems, fever, and weight loss were more often recognized by physicians than other symptoms. Agreement between patients and physicians was poor to moderate, with Kappa statistics ranging from 0.17 (dry mouth) to 0.58 (fever). Recognition was independently more likely for ambulatory patients (adjusted odds ratio 1.69, P < 0.001) and for patients seen as sicker (adjusted odds ratio 1.88, P < 0.001). Appropriate symptom management requires improved symptom recognition. More systematic clinical examinations, including attentive patient interview, are needed.

An Estimate of the Proportion of Symptoms Reported in Self-Administered Questionnaires That Are Captured as Adverse Drug Events in an Observational Database

“…All records for changes in body shape are removed for chronicity; the questionnaire did not distinguish between loss and gain events and whether they had separate onsets. individuals [14][15][16] and in other patient populations. 9,17 A 20-item self-completed HIV symptom index has been developed in an effort to standardize reporting and improve completeness of symptom documentation.…”

Agreement between self-report and medical records on signs and symptoms of respiratory illness

“…[17][18][19][20][21][22] Symptom research has looked at patient-clinician agreement of symptoms related to angina pectoris, 23 myocardial infarction, 24,25 psychological and somatic disorders, 8,[26][27][28][29] HIV infection, 30 and cancer. 31,32 One study found fair to substantial agreement between adult selfassessment and clinician assessment on the symptoms related to 'strep throat'.…”

Demographic and Illness-Related Variables Associated With HIV-Related Fatigue

“…Fatigue is the most frequent and debilitating complaint of HIV-positive people, with prevalence rates of up to 98% in studies of seropositive individuals (e.g., Anandan, Braveman, Kielhofner, & Forsyth, 2006;Breitbart, McDonald, Rosenfeld, Monkman, & Passik, 1998;Coleman et al, 2006;Duran et al, 2001;Fontaine, Larue, & Lassauniere, 1999;Henderson, Safa, Easterbrook, & Hotopf, 2005;Molassiotis, Callaghan, Twinn, & Lam, 2001;Norval, 2004;Simmonds, Novy, & Sandoval, 2005;Sullivan, Dworkin, & the Adult and Adolescent Spectrum of HIV Disease Investigators, 2003;Vogl et al, 1999;Voss, 2002Voss, , 2005. The consequences of fatigue include having to stop working, limiting one's involvement with family and friends, being unable to manage one's finances, and needing an entire day to get through the simplest of household chores (Anandan et al, 2006;Barroso, 2001;Jenkin, Koch, & Kralik, 2006).…”