McInnes D Keith, Hardy Hélène, Goetz Matthew B, Skolnik Paul R, Brewster Amanda L, Hofmann Roger H, Gifford Allen L
VA QUERI Program and Center for Health Quality, Outcomes and Economic Research, VA New England Healthcare System, Bedford, MA, USA.
J Int Assoc Provid AIDS Care. 2013 Nov-Dec;12(6):397-406. doi: 10.1177/1545109712454333. Epub 2012 Sep 11.
HIV medication nonadherence is a major problem, yet many providers lack the time and training to carefully ask patients about their adherence.
To design and pilot a technology-assisted intervention, for use in clinical settings, to identify nonadherent patients.
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.
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.
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.
艾滋病毒治疗的不依从是一个主要问题，但许多医疗服务提供者缺乏时间和培训来仔细询问患者的依从情况。
设计并试行一种技术辅助干预措施，用于临床环境，以识别不依从的患者。
该干预措施使用音频计算机辅助自我访谈（ACASI）来改善对依从性和药物相关问题的评估。患者完成一个触摸屏计算机ACASI，该设备生成图形化的临床医生和患者报告，以便在临床会诊期间进行讨论。
72名患者和11名医疗服务提供者参与了这项研究。患者轻松完成了ACASI。3天的依从率为63%，30天的依从率为47%。使用ACASI时，22%的患者在其医疗服务提供者认为他们依从的情况下，自认为不依从。
这种基于ACASI的干预措施易于使用，并有助于识别不依从情况。试点测试带来了改进，包括增加基于电话的依从性咨询。一项更大规模的试验正在进行，以评估该干预措施是否能改善与艾滋病毒相关的结果。
