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Development and field testing of an HIV medication touch screen computer patient adherence tool with telephone-based, targeted adherence counseling.

McInnes DK, Hardy H, Goetz MB, Skolnik PR, Brewster AL, Hofmann RH, Gifford AL. Development and field testing of an HIV medication touch screen computer patient adherence tool with telephone-based, targeted adherence counseling. Journal of the International Association of Providers of AIDS Care. 2013 Nov 1; 12(6):397-406.

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Abstract:

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.





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