Crane Heidi M, Lober William, Webster Eric, Harrington Robert D, Crane Paul K, Davis Thomas E, Kitahata Mari M
The Department of Medicine, University of Washington, Seattle, Washington, USA.
Curr HIV Res. 2007 Jan;5(1):109-18. doi: 10.2174/157016207779316369.
Information from patient-reported outcomes (PROs) can enhance patient-provider communication and facilitate clinical research. However, there are barriers to collecting PROs within a clinic. Recent technological advances may help overcome these barriers. We examined the feasibility of using a web-based application on tablet PCs with touch screens to collect PROs in a busy, multi-provider, outpatient HIV clinical care setting.
Patients presenting for routine care were asked to complete a touch-screen-based assessment containing 62 to 111 items depending on patient responses. The assessment included instruments measuring body morphology abnormalities, depression, symptom burden, medication adherence, drug/alcohol/tobacco use, and health-related quality of life.
Of 136 patients approached to participate in the study, 106 patients (78%) completed the assessment, 6 (4%) started but did not complete it, and 24 (18%) refused. Of those who completed the assessment, the mean age was 48 years, and 29% reported a history of injection drug use. The median time to complete the assessment was 12 minutes. The prevalence of lipoatrophy was 51%, the prevalence of lipohypertrophy was 69%, and the prevalence of moderate or severe depression was 51%. We found that 25% of those receiving highly active antiretroviral therapy noted missing a dose of their antiretroviral medications in the prior 4 days.
Collection of PROs using touch-screen-based, internet technology was feasible in a busy HIV clinic. We found a high prevalence of body morphology abnormalities, depression, and poor adherence. Touch-screen-based collection of PROs is a promising tool to facilitate research and clinical care.
患者报告结局(PROs)提供的信息可加强医患沟通并推动临床研究。然而,在诊所内收集PROs存在障碍。近期的技术进步可能有助于克服这些障碍。我们研究了在繁忙的、多医生坐诊的门诊HIV临床护理环境中,使用基于网络的应用程序在触摸屏平板电脑上收集PROs的可行性。
要求前来接受常规护理的患者完成一项基于触摸屏的评估,评估项目根据患者的回答包含62至111项。该评估包括测量身体形态异常、抑郁、症状负担、药物依从性、药物/酒精/烟草使用情况以及健康相关生活质量的工具。
在邀请参与研究的136名患者中,106名患者(78%)完成了评估,6名患者(4%)开始评估但未完成,24名患者(18%)拒绝参与。在完成评估的患者中,平均年龄为48岁,29%的患者报告有注射吸毒史。完成评估的中位时间为12分钟。脂肪萎缩的患病率为51%,脂肪增生的患病率为69%,中度或重度抑郁的患病率为51%。我们发现,在接受高效抗逆转录病毒治疗的患者中,25%的人表示在之前4天内有漏服抗逆转录病毒药物的情况。
在繁忙的HIV诊所中,使用基于触摸屏的互联网技术收集PROs是可行的。我们发现身体形态异常、抑郁和依从性差的患病率很高。基于触摸屏收集PROs是促进研究和临床护理的一个有前景的工具。