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

J Int Assoc Provid AIDS Care. 2013 Nov-Dec;12(6):397-406. doi: 10.1177/1545109712454333. Epub 2012 Sep 11.

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.

Keywords: HIV; computers; medication adherence; medication reconciliation; patient adherence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Counseling / methods*
  • Drug Therapy, Computer-Assisted / instrumentation*
  • Drug Therapy, Computer-Assisted / methods*
  • HIV Infections / drug therapy*
  • HIV Infections / psychology*
  • Humans
  • Medical Order Entry Systems
  • Medication Adherence*
  • Middle Aged
  • Pilot Projects
  • Surveys and Questionnaires
  • Telephone
  • Young Adult