Utility and Impact of the Implementation of Same-Day, Self-administered Electronic Patient-Reported Outcomes Assessments in Routine HIV Care in two North American Clinics

Abstract

The PROgress study assessed the value and feasibility of implementing web-based patient-reported outcomes assessments (PROs) within routine HIV care at two North American outpatient clinics. People with HIV (PWH) completed PROs on a tablet computer in clinic before their routine care visit. Data collection included PROs from 1632 unique PWH, 596 chart reviews, 200 patient questionnaires, and 16 provider/staff questionnaires. During an initial setup phase involving 200 patients, PRO results were not delivered to providers; for all subsequent patients, providers received PRO results before the consultation. Chart review demonstrated that delivery of PRO results to providers improved patient-provider communication and increased the number of complex health and behavioral issues identified, recorded, and acted on, including suicidal ideation (88% with vs 38% without PRO feedback) and anxiety (54% with vs 24% without PRO feedback). In post-visit questionnaires, PWH (82%) and providers (82%) indicated that the PRO added value to the visit.

Implementation of thyroid-related patient-reported outcomes in routine clinical practice

“…Potential mechanisms were early responsiveness to symptoms preventing adverse downstream consequences and ability to tolerate chemotherapy longer than the usual care group. Short et al assessed the value and feasibility of web-based PRO assessments within routine HIV care (53). The study included 1630 HIV patients who completed PROs in the outpatient clinic before their routine care consultation.…”

“…Short et al. assessed the value and feasibility of web-based PRO assessments within routine HIV care ( 53 ). The study included 1630 HIV patients who completed PROs in the outpatient clinic before their routine care consultation.…”

Risk Factors for Suboptimal Adherence Identified by Patient-Reported Outcomes Assessments in Routine HIV Care at 2 North American Clinics

“…Detailed methodology has been previously described. 13 Eligible participants were aged ≥18 years with a diagnosis of HIV who attended a participating clinic for a routine visit during the study period and could sufficiently speak and understand English, Spanish, and/or Haitian Creole to be able to complete the PRO. Individuals with psychiatric, cognitive, or motor impairment and those visiting the clinic for a non-routine reason (ie, acute illness or injury) or to see a provider other than their primary HIV care provider were excluded.…”

“…8 Screening assessments using patient-reported outcomes assessments (PROs) in routine HIV care can improve patient-provider communication and focus provider attention on symptoms or behaviors that may not otherwise be addressed, such as mental health issues and substance use. [9][10][11][12][13][14] Information obtained through PROs may also aid providers in identifying barriers to ART adherence among their patients. 15 For example, previous studies have demonstrated that substance use, depression, and dissatisfaction with ART are associated with suboptimal ART adherence among PWH who completed PROs at routine HIV clinic visits.…”

“…8,15 The PROgress study evaluated the implementation of PROs into routine HIV care at 2 outpatient clinics in North America and assessed the added value of PRO implementation for healthcare providers and PWH. 13 In the PROgress study, both healthcare providers and PWH found that PRO administration before clinic visits was useful, facilitated the discussion of sensitive topics, and improved overall patient care. Here we examine the association between sociodemographic and health-related factors obtained through PROs and suboptimal adherence to ART among PWH enrolled in the PROgress study.…”